Sentinel lymph node mapping and intraoperative assessment in a
prospective, international, multicentre, observational trial of
patients with cervical cancer: The SENTIX trial

J 2020

Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial

CIBULA, David; Roman KOCIAN; Andrea PLAIKNER; Jiří JARKOVSKÝ; Jaroslav KLAT et al.

Základní údaje

Originální název

Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial

Autoři

Vydání

European Journal of Cancer, Oxford, Elsevier Science Inc. 2020, 0959-8049

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 9.162

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/20:00116468

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Cervical cancer; Sentinel lymph node; Frozen section; Mapping; Ultrastaging; Micrometastases

Štítky

14110411, 14119612, GPK, GPKonko, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 22. 9. 2020 14:09, Mgr. Tereza Miškechová

Anotace

V originále

Background: SENTIX (ENGOT-CX2/CEEGOG-CX1) is an international, multi centre, prospective observational trial evaluating sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We report the final preplanned analysis of the secondary end-points: SLN mapping and outcomes of intraoperative SLN pathology. Methods: Forty-seven sites (18 countries) with experience of SLN biopsy participated in SENTIX. We preregistered patients with stage IA1/lymphovascular space invasion-positive to IB2 (4 cm or smaller or 2 cm or smaller for fertility-sparing treatment) cervical cancer without suspicious lymph nodes on imaging before surgery. SLN frozen section assessment and pathological ultrastaging were mandatory. Patients were registered postoperatively if SLN were bilaterally detected in the pelvis, and frozen sections were negative. Trial registration: ClinicalTrials.gov (NCT02494063). Results: We analysed data for 395 preregistered patients. Bilateral detection was achieved in 91% (355/395), and it was unaffected by tumour size, tumour stage or body mass index, but it was lower in older patients, in patients who underwent open surgery, and in sites with fewer cases. No SLN were found outside the seven anatomical pelvic regions. Most SLN and positive SLN were localised below the common iliac artery bifurcation. Single positive SLN above the iliac bifurcation were found in 2% of cases. Frozen sections failed to detect 54% of positive lymph nodes (pN1), including 28% of cases with macrometastases and 90% with micrometastases. Interpretation: SLN biopsy can achieve high bilateral SLN detection in patients with tumours of 4 cm or smaller. At experienced centres, all SLN were found in the pelvis, and most were located below the iliac vessel bifurcation. SLN frozen section assessment is an unreliable tool for intraoperative triage because it only detects about half of N1 cases. (C) 2020 The Author(s). Published by Elsevier Ltd.

Citovat

CIBULA, David; Roman KOCIAN; Andrea PLAIKNER; Jiří JARKOVSKÝ; Jaroslav KLAT; Ignacio ZAPARDIEL; Radovan PILKA; Aureli TORNE; Borek SEHNAL; Marcela OSTOJICH; Almerinda PETIZ; Octavio A. SANCHEZ; Jiri PRESL; Alessandro BUDA; Francesco RASPAGLIESI; Peter KASCAK; Luc VAN LONKHUIJZEN; Marc BARAHONA; Luboš MINÁŘ; Pawel BLECHARZ; Maja PAKIZ; Dariusz WYDRA; Leon C. SNYMAN; Kamil ZALEWSKI; Cristina ZORRERO; Havelka HAVELKA; Mikulas REDECHA; Alla VINNYTSKA; Ignace VERGOTE; Solveig TINGULSTAD; Martin MICHAL; Barbara KIPP; Slama SLAMA; Simone MARNITZ; Sylva BAJSOVA; Alicia HERNANDEZ; Daniela FISCHEROVA; Kristyna NEMEJCOVA a Christhardt KOHLER. Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial. European Journal of Cancer. Oxford: Elsevier Science Inc., 2020, roč. 137, SEP 2020, s. 69-80. ISSN 0959-8049. Dostupné z: https://doi.org/10.1016/j.ejca.2020.06.034.

@article{1680201,
   author = {Cibula, David and Kocian, Roman and Plaikner, Andrea and Jarkovský, Jiří and Klat, Jaroslav and Zapardiel, Ignacio and Pilka, Radovan and Torne, Aureli and Sehnal, Borek and Ostojich, Marcela and Petiz, Almerinda and Sanchez, Octavio A. and Presl, Jiri and Buda, Alessandro and Raspagliesi, Francesco and Kascak, Peter and van Lonkhuijzen, Luc and Barahona, Marc and Minář, Luboš and Blecharz, Pawel and Pakiz, Maja and Wydra, Dariusz and Snyman, Leon C. and Zalewski, Kamil and Zorrero, Cristina and Havelka, Havelka and Redecha, Mikulas and Vinnytska, Alla and Vergote, Ignace and Tingulstad, Solveig and Michal, Martin and Kipp, Barbara and Slama, Slama and Marnitz, Simone and Bajsova, Sylva and Hernandez, Alicia and Fischerova, Daniela and Nemejcova, Kristyna and Kohler, Christhardt},
   article_location = {Oxford},
   article_number = {SEP 2020},
   doi = {https://doi.org/10.1016/j.ejca.2020.06.034},
   keywords = {Cervical cancer; Sentinel lymph node; Frozen section; Mapping; Ultrastaging; Micrometastases},
   language = {eng},
   issn = {0959-8049},
   journal = {European Journal of Cancer},
   title = {Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial},
   url = {https://www.ejcancer.com/article/S0959-8049(20)30367-1/pdf},
   volume = {137},
   year = {2020}
}

TY  - JOUR
ID  - 1680201
AU  - Cibula, David - Kocian, Roman - Plaikner, Andrea - Jarkovský, Jiří - Klat, Jaroslav - Zapardiel, Ignacio - Pilka, Radovan - Torne, Aureli - Sehnal, Borek - Ostojich, Marcela - Petiz, Almerinda - Sanchez, Octavio A. - Presl, Jiri - Buda, Alessandro - Raspagliesi, Francesco - Kascak, Peter - van Lonkhuijzen, Luc - Barahona, Marc - Minář, Luboš - Blecharz, Pawel - Pakiz, Maja - Wydra, Dariusz - Snyman, Leon C. - Zalewski, Kamil - Zorrero, Cristina - Havelka, Havelka - Redecha, Mikulas - Vinnytska, Alla - Vergote, Ignace - Tingulstad, Solveig - Michal, Martin - Kipp, Barbara - Slama, Slama - Marnitz, Simone - Bajsova, Sylva - Hernandez, Alicia - Fischerova, Daniela - Nemejcova, Kristyna - Kohler, Christhardt
PY  - 2020
TI  - Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial
JF  - European Journal of Cancer
VL  - 137
IS  - SEP 2020
SP  - 69-80
EP  - 69-80
PB  - Elsevier Science Inc.
SN  - 09598049
KW  - Cervical cancer
KW  - Sentinel lymph node
KW  - Frozen section
KW  - Mapping
KW  - Ultrastaging
KW  - Micrometastases
UR  - https://www.ejcancer.com/article/S0959-8049(20)30367-1/pdf
L2  - https://www.ejcancer.com/article/S0959-8049(20)30367-1/pdf
N2  - Background: SENTIX (ENGOT-CX2/CEEGOG-CX1) is an international, multi centre, prospective observational trial evaluating sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We report the final preplanned analysis of the secondary end-points: SLN mapping and outcomes of intraoperative SLN pathology. Methods: Forty-seven sites (18 countries) with experience of SLN biopsy participated in SENTIX. We preregistered patients with stage IA1/lymphovascular space invasion-positive to IB2 (4 cm or smaller or 2 cm or smaller for fertility-sparing treatment) cervical cancer without suspicious lymph nodes on imaging before surgery. SLN frozen section assessment and pathological ultrastaging were mandatory. Patients were registered postoperatively if SLN were bilaterally detected in the pelvis, and frozen sections were negative. Trial registration: ClinicalTrials.gov (NCT02494063). Results: We analysed data for 395 preregistered patients. Bilateral detection was achieved in 91% (355/395), and it was unaffected by tumour size, tumour stage or body mass index, but it was lower in older patients, in patients who underwent open surgery, and in sites with fewer cases. No SLN were found outside the seven anatomical pelvic regions. Most SLN and positive SLN were localised below the common iliac artery bifurcation. Single positive SLN above the iliac bifurcation were found in 2% of cases. Frozen sections failed to detect 54% of positive lymph nodes (pN1), including 28% of cases with macrometastases and 90% with micrometastases. Interpretation: SLN biopsy can achieve high bilateral SLN detection in patients with tumours of 4 cm or smaller. At experienced centres, all SLN were found in the pelvis, and most were located below the iliac vessel bifurcation. SLN frozen section assessment is an unreliable tool for intraoperative triage because it only detects about half of N1 cases. (C) 2020 The Author(s). Published by Elsevier Ltd.
ER  -

CIBULA, David; Roman KOCIAN; Andrea PLAIKNER; Jiří JARKOVSKÝ; Jaroslav KLAT; Ignacio ZAPARDIEL; Radovan PILKA; Aureli TORNE; Borek SEHNAL; Marcela OSTOJICH; Almerinda PETIZ; Octavio A. SANCHEZ; Jiri PRESL; Alessandro BUDA; Francesco RASPAGLIESI; Peter KASCAK; Luc VAN LONKHUIJZEN; Marc BARAHONA; Luboš MINÁŘ; Pawel BLECHARZ; Maja PAKIZ; Dariusz WYDRA; Leon C. SNYMAN; Kamil ZALEWSKI; Cristina ZORRERO; Havelka HAVELKA; Mikulas REDECHA; Alla VINNYTSKA; Ignace VERGOTE; Solveig TINGULSTAD; Martin MICHAL; Barbara KIPP; Slama SLAMA; Simone MARNITZ; Sylva BAJSOVA; Alicia HERNANDEZ; Daniela FISCHEROVA; Kristyna NEMEJCOVA a Christhardt KOHLER. Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial. \textit{European Journal of Cancer}. Oxford: Elsevier Science Inc., 2020, roč.~137, SEP 2020, s.~69-80. ISSN~0959-8049. Dostupné z: https://doi.org/10.1016/j.ejca.2020.06.034.

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