Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma
To assess survival among patients diagnosed with uterine carcinosarcoma (CS) who underwent sentinel lymph node (SLN) biopsy alone vs. systematic lymph node dissection (LND). We identified newly diagnosed CS patients who underwent primary surgical management from January 1996–December 2019. The SLN c...
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| Veröffentlicht in: | Gynecologic oncology 2022-05, Vol.165 (2), p.287-292 |
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| creator | Zammarrelli, William A. Greenman, Michelle Rios-Doria, Eric Miller, Katie Broach, Vance Mueller, Jennifer J. Aviki, Emeline Alektiar, Kaled M. Soslow, Robert A. Ellenson, Lora H. Makker, Vicky Abu-Rustum, Nadeem R. Leitao, Mario M. |
| description | To assess survival among patients diagnosed with uterine carcinosarcoma (CS) who underwent sentinel lymph node (SLN) biopsy alone vs. systematic lymph node dissection (LND).
We identified newly diagnosed CS patients who underwent primary surgical management from January 1996–December 2019. The SLN cohort underwent SLN biopsy alone with bilateral SLNs identified. The systematic LND cohort did not undergo SLN biopsy.
Ninety-nine patients underwent SLN biopsy, and 100 patients underwent systematic LND. There was no difference by age, stage, body mass index, myoinvasion ( |
| doi_str_mv | 10.1016/j.ygyno.2022.02.012 |
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We identified newly diagnosed CS patients who underwent primary surgical management from January 1996–December 2019. The SLN cohort underwent SLN biopsy alone with bilateral SLNs identified. The systematic LND cohort did not undergo SLN biopsy.
Ninety-nine patients underwent SLN biopsy, and 100 patients underwent systematic LND. There was no difference by age, stage, body mass index, myoinvasion (<50%, ≥50%), lymphovascular space invasion, or positive washings. Eighty-five SLN (85.9%) and 15 LND (15%) underwent minimally invasive surgery (P < 0.001). The median total node count was four (range, 1–13) for SLN and 19 (range, 2–50) for LND (P < 0.001). Nodal metastasis occurred in 23 (23.2%) SLN and in 22 (22%) LND (P = 0.4). Postoperative therapy was administered to 85 (85.9%) SLN and 71 (71%) LND (P = 0.02). Median follow-up was 33 months (range, 1–205) for SLN and 55.3 months (range, 1–269) for LND (P = 0.001). The three-year progression-free survival (PFS) was 62.9% (SE 5.2%) for SLN and 52.3% (SE 5.3%) for LND (P = 0.13). The three-year overall survival (OS) was 72.1% (SE 5.1%) for SLN and 71.6% (SE 4.6%) for LND (P = 0.68). An isolated nodal recurrence occurred in two (2%) SLN and four (4%) LND (P = 0.26).
There is no difference in PFS or OS among CS patients who undergo SLN biopsy vs. systematic LND. SLN biopsy detects nodal metastasis without compromising oncologic outcomes.
•Systematic LND showed no survival benefit vs. SLN biopsy alone in patients with uterine carcinosarcoma.•There is no difference in detection of nodal metastasis in SLN biopsy alone vs. systematic LND.•SLN biopsy in place of systematic LND does not compromise oncologic outcome.</description><identifier>ISSN: 0090-8258</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2022.02.012</identifier><identifier>PMID: 35232588</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Carcinosarcoma - surgery ; Humans ; Lymph Node Excision ; Medical Oncology ; Progression-Free Survival ; Sentinel Lymph Node Biopsy ; Systematic lymphadenectomy ; Transforming Growth Factor beta ; Uterine carcinosarcoma</subject><ispartof>Gynecologic oncology, 2022-05, Vol.165 (2), p.287-292</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-6a9818a29469cbfb648d2d9ba4329110575d48d8323663aafa9340e540aae0043</citedby><cites>FETCH-LOGICAL-c459t-6a9818a29469cbfb648d2d9ba4329110575d48d8323663aafa9340e540aae0043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090825822001226$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35232588$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zammarrelli, William A.</creatorcontrib><creatorcontrib>Greenman, Michelle</creatorcontrib><creatorcontrib>Rios-Doria, Eric</creatorcontrib><creatorcontrib>Miller, Katie</creatorcontrib><creatorcontrib>Broach, Vance</creatorcontrib><creatorcontrib>Mueller, Jennifer J.</creatorcontrib><creatorcontrib>Aviki, Emeline</creatorcontrib><creatorcontrib>Alektiar, Kaled M.</creatorcontrib><creatorcontrib>Soslow, Robert A.</creatorcontrib><creatorcontrib>Ellenson, Lora H.</creatorcontrib><creatorcontrib>Makker, Vicky</creatorcontrib><creatorcontrib>Abu-Rustum, Nadeem R.</creatorcontrib><creatorcontrib>Leitao, Mario M.</creatorcontrib><title>Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>To assess survival among patients diagnosed with uterine carcinosarcoma (CS) who underwent sentinel lymph node (SLN) biopsy alone vs. systematic lymph node dissection (LND).
We identified newly diagnosed CS patients who underwent primary surgical management from January 1996–December 2019. The SLN cohort underwent SLN biopsy alone with bilateral SLNs identified. The systematic LND cohort did not undergo SLN biopsy.
Ninety-nine patients underwent SLN biopsy, and 100 patients underwent systematic LND. There was no difference by age, stage, body mass index, myoinvasion (<50%, ≥50%), lymphovascular space invasion, or positive washings. Eighty-five SLN (85.9%) and 15 LND (15%) underwent minimally invasive surgery (P < 0.001). The median total node count was four (range, 1–13) for SLN and 19 (range, 2–50) for LND (P < 0.001). Nodal metastasis occurred in 23 (23.2%) SLN and in 22 (22%) LND (P = 0.4). Postoperative therapy was administered to 85 (85.9%) SLN and 71 (71%) LND (P = 0.02). Median follow-up was 33 months (range, 1–205) for SLN and 55.3 months (range, 1–269) for LND (P = 0.001). The three-year progression-free survival (PFS) was 62.9% (SE 5.2%) for SLN and 52.3% (SE 5.3%) for LND (P = 0.13). The three-year overall survival (OS) was 72.1% (SE 5.1%) for SLN and 71.6% (SE 4.6%) for LND (P = 0.68). An isolated nodal recurrence occurred in two (2%) SLN and four (4%) LND (P = 0.26).
There is no difference in PFS or OS among CS patients who undergo SLN biopsy vs. systematic LND. SLN biopsy detects nodal metastasis without compromising oncologic outcomes.
•Systematic LND showed no survival benefit vs. SLN biopsy alone in patients with uterine carcinosarcoma.•There is no difference in detection of nodal metastasis in SLN biopsy alone vs. systematic LND.•SLN biopsy in place of systematic LND does not compromise oncologic outcome.</description><subject>Carcinosarcoma - surgery</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Medical Oncology</subject><subject>Progression-Free Survival</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Systematic lymphadenectomy</subject><subject>Transforming Growth Factor beta</subject><subject>Uterine carcinosarcoma</subject><issn>0090-8258</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1r3DAQFaUl2ab5BYWiYy_ejiTblQ4tlNAvCPTQ9izG8mxWiy25kjfF_75yNw3NJTAwMPPmveE9xl4K2AoQ7ZvDdrlZQtxKkHILpYR8wjYCTFO1ujFP2QbAQKVlo8_Z85wPAKAK6Iydq0aqMtYbFr9TmH2ggQ_LOO15iD3xzscpLxyHGIi7OE6YqOdz5HnJM404e3eCY0-B3BzHhfvAp7IobJn_9vOeH2dKfr3H5HyIubQ44gv2bIdDpsu7fsF-fvr44-pLdf3t89erD9eVqxszVy0aLTRKU7fGdbuurXUve9NhraQRApq3TV9GWknVtgpxh0bVQE0NiARQqwv2_sQ7HbuRelf-SjjYKfkR02IjevtwE_ze3sRba6CtjZGF4PUdQYq_jpRnO_rsaBgwUDxmK9vVRG20KVB1groUc060u5cRYNeo7MH-jcquUVkoJVaBV_9_eH_zL5sCeHcCUPHp1lOy2RV_HfU-FdNtH_2jAn8A3Lep4g</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Zammarrelli, William A.</creator><creator>Greenman, Michelle</creator><creator>Rios-Doria, Eric</creator><creator>Miller, Katie</creator><creator>Broach, Vance</creator><creator>Mueller, Jennifer J.</creator><creator>Aviki, Emeline</creator><creator>Alektiar, Kaled M.</creator><creator>Soslow, Robert A.</creator><creator>Ellenson, Lora H.</creator><creator>Makker, Vicky</creator><creator>Abu-Rustum, Nadeem R.</creator><creator>Leitao, Mario M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220501</creationdate><title>Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma</title><author>Zammarrelli, William A. ; Greenman, Michelle ; Rios-Doria, Eric ; Miller, Katie ; Broach, Vance ; Mueller, Jennifer J. ; Aviki, Emeline ; Alektiar, Kaled M. ; Soslow, Robert A. ; Ellenson, Lora H. ; Makker, Vicky ; Abu-Rustum, Nadeem R. ; Leitao, Mario M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-6a9818a29469cbfb648d2d9ba4329110575d48d8323663aafa9340e540aae0043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Carcinosarcoma - surgery</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Medical Oncology</topic><topic>Progression-Free Survival</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Systematic lymphadenectomy</topic><topic>Transforming Growth Factor beta</topic><topic>Uterine carcinosarcoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zammarrelli, William A.</creatorcontrib><creatorcontrib>Greenman, Michelle</creatorcontrib><creatorcontrib>Rios-Doria, Eric</creatorcontrib><creatorcontrib>Miller, Katie</creatorcontrib><creatorcontrib>Broach, Vance</creatorcontrib><creatorcontrib>Mueller, Jennifer J.</creatorcontrib><creatorcontrib>Aviki, Emeline</creatorcontrib><creatorcontrib>Alektiar, Kaled M.</creatorcontrib><creatorcontrib>Soslow, Robert A.</creatorcontrib><creatorcontrib>Ellenson, Lora H.</creatorcontrib><creatorcontrib>Makker, Vicky</creatorcontrib><creatorcontrib>Abu-Rustum, Nadeem R.</creatorcontrib><creatorcontrib>Leitao, Mario M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zammarrelli, William A.</au><au>Greenman, Michelle</au><au>Rios-Doria, Eric</au><au>Miller, Katie</au><au>Broach, Vance</au><au>Mueller, Jennifer J.</au><au>Aviki, Emeline</au><au>Alektiar, Kaled M.</au><au>Soslow, Robert A.</au><au>Ellenson, Lora H.</au><au>Makker, Vicky</au><au>Abu-Rustum, Nadeem R.</au><au>Leitao, Mario M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>165</volume><issue>2</issue><spage>287</spage><epage>292</epage><pages>287-292</pages><issn>0090-8258</issn><eissn>1095-6859</eissn><abstract>To assess survival among patients diagnosed with uterine carcinosarcoma (CS) who underwent sentinel lymph node (SLN) biopsy alone vs. systematic lymph node dissection (LND).
We identified newly diagnosed CS patients who underwent primary surgical management from January 1996–December 2019. The SLN cohort underwent SLN biopsy alone with bilateral SLNs identified. The systematic LND cohort did not undergo SLN biopsy.
Ninety-nine patients underwent SLN biopsy, and 100 patients underwent systematic LND. There was no difference by age, stage, body mass index, myoinvasion (<50%, ≥50%), lymphovascular space invasion, or positive washings. Eighty-five SLN (85.9%) and 15 LND (15%) underwent minimally invasive surgery (P < 0.001). The median total node count was four (range, 1–13) for SLN and 19 (range, 2–50) for LND (P < 0.001). Nodal metastasis occurred in 23 (23.2%) SLN and in 22 (22%) LND (P = 0.4). Postoperative therapy was administered to 85 (85.9%) SLN and 71 (71%) LND (P = 0.02). Median follow-up was 33 months (range, 1–205) for SLN and 55.3 months (range, 1–269) for LND (P = 0.001). The three-year progression-free survival (PFS) was 62.9% (SE 5.2%) for SLN and 52.3% (SE 5.3%) for LND (P = 0.13). The three-year overall survival (OS) was 72.1% (SE 5.1%) for SLN and 71.6% (SE 4.6%) for LND (P = 0.68). An isolated nodal recurrence occurred in two (2%) SLN and four (4%) LND (P = 0.26).
There is no difference in PFS or OS among CS patients who undergo SLN biopsy vs. systematic LND. SLN biopsy detects nodal metastasis without compromising oncologic outcomes.
•Systematic LND showed no survival benefit vs. SLN biopsy alone in patients with uterine carcinosarcoma.•There is no difference in detection of nodal metastasis in SLN biopsy alone vs. systematic LND.•SLN biopsy in place of systematic LND does not compromise oncologic outcome.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35232588</pmid><doi>10.1016/j.ygyno.2022.02.012</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Carcinosarcoma - surgery Humans Lymph Node Excision Medical Oncology Progression-Free Survival Sentinel Lymph Node Biopsy Systematic lymphadenectomy Transforming Growth Factor beta Uterine carcinosarcoma |
| title | Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma |
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