Sentinel node mapping, sentinel node mapping plus back-up lymphadenectomy, and lymphadenectomy in Early-sTage cERvical caNcer scheduled for fertilItY-sparing approach: The ETERNITY project

To investigate the safety of sentinel node mapping for patients with early-stage cervical cancer undergoing cervical conization plus nodal evaluation. The ETERNITY project is a retrospective, multi-institutional study collecting data of patients with early-stage cervical cancer undergoing fertility-...

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Veröffentlicht in:European journal of surgical oncology 2024-09, Vol.50 (9), p.108467, Article 108467
Hauptverfasser: Bogani, Giorgio, Scambia, Giovanni, Fagotti, Anna, Fanfani, Francesco, Ciavattini, Andrea, Sopracordevole, Francesco, Malzoni, Mario, Casarin, Jvan, Ghezzi, Fabio, Vizza, Enrico, Cosentino, Francesco, Berretta, Roberto, Cuccu, Ilaria, Ferrari, Filippo Alberto, Chiappa, Valentina, Vizzielli, Giuseppe, Raspagliesi, Francesco, De Vincenzo, Rosa, Clemente, Nicolò, Del Fabro, Anna, Buttignol, Monica, Cianci, Stefano, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Falcone, Francesca, Petrillo, Marco, Capobianco, Giampiero, Scarfone, Giovanna, Casaccia, Filippo, Fichera, Mariasole, Leo, Livio, Sozzi, Giulio, Colalillo, Alessio, Gardella, Barbara, Serrachioli, Renato, Raimondo, Diego, Chiantera, Vito, Ercoli, Alfredo, Dominoni, Mattia, Zupi, Enrico, Centini, Gabriele, Uccella, Stefano, Franchi, Massimo, Perrone, Anna Myriam, De Iaco, Pierandrea, Multinu, Francesco, Zanagnolo, Vanna, Schivardi, Gabriella, De Vitis, Luigi Antonio, Ferrari, Federico, Restaino, Stefano, Driul, Lorenza, Arcieri, Martina, Sorbi, Flavia, Fambrini, Massimiliano, Aguzzoli, Lorenzo, Mandato, Vincenzo Dario, Murina, Filippo, Solima, Eugenio, Vignali, Michele, Vercellini, Paolo, Ceccaroni, Marcello, Di Donato, Violante, Giannini, Andrea, Muzii, Ludovico, Palladino, Simona, Tozzi, Roberto, Cormio, Gennaro
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Zusammenfassung:To investigate the safety of sentinel node mapping for patients with early-stage cervical cancer undergoing cervical conization plus nodal evaluation. The ETERNITY project is a retrospective, multi-institutional study collecting data of patients with early-stage cervical cancer undergoing fertility-sparing treatment. Here, we compared outcomes related to three methods of nodal assessment: sentinel node mapping (SNM), SNM plus backup lymphadenectomy (SNM + LND); pelvic lymphadenectomy (LND). Charts of 123 patients (with stage IA1-IB1 cervical cancer) were evaluated. Median patients’ age was 34 (range, 22–44) years. SNM, SNM + LND, and LND were performed in 32 (26 %), 31 (25.2 %), and 60 (48.8 %) patients, respectively. Overall, eight (6.5 %) patients were diagnosed with positive nodes. Two (3.3 %), three (9.7 %), and three (9.4 %) patients were detected in patients who had LND, SNM + LND, and SNM respectively. Considering the 63 patients undergoing SNM (31 SNM + LND and 32 SNM alone), macrometastases, micrometastases, and isolated tumor cells were detected in four (3.2 %), three (2.4 %), and one (0.8 %) patients, respectively. All patients with positive nodes discontinued the fertility sparing treatment. Other two patients (one (1.7 %) in the LND group and one (3.1 %) in the SNM group) required hysterectomy even after negative nodal evaluation. After a median follow-up of 53.6 (range, 1.3, 158.0) months, nine (7.3 %) and two (1.6 %) patients developed cervical and pelvic nodes recurrences, respectively. Disease-free (p = 0.332, log-rank test) and overall survival (p = 0.769, log-rank test) were similar among groups. In this retrospective experience, SNM upholds long-term oncologic effectiveness of LND, reducing morbidity.
ISSN:0748-7983
1532-2157
1532-2157
DOI:10.1016/j.ejso.2024.108467