J 2024

Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer

KOCIAN, Roman, Christhardt KOHLER, Sylva BAJSOVA, Jiří JARKOVSKÝ, Ignacio ZAPARDIEL et. al.

Základní údaje

Originální název

Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer

Autoři

KOCIAN, Roman (203 Česká republika), Christhardt KOHLER, Sylva BAJSOVA (203 Česká republika), Jiří JARKOVSKÝ (203 Česká republika, domácí), Ignacio ZAPARDIEL, Di Martino GIAMPAOLO, Luc VAN LONKHUIJZEN, Borek SEHNAL (203 Česká republika), Octavio Arencibia SANCHEZ, Blanca GIL-IBANEZ, Fabio MARTINELLI, Jiri PRESL (203 Česká republika), Luboš MINÁŘ (203 Česká republika, domácí), Radovan PILKA (203 Česká republika), Peter KASCAK, Pavel HAVELKA (203 Česká republika), Martin MICHAL (203 Česká republika), Toon VAN GORP, Kristyna NEMEJCOVA (203 Česká republika), Pavel DUNDR (203 Česká republika) a David CIBULA (203 Česká republika)

Vydání

Gynecologic oncology, SAN DIEGO, ACADEMIC PRESS INC ELSEVIER SCIENCE, 2024, 0090-8258

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 4.700 v roce 2022

Organizační jednotka

Lékařská fakulta

UT WoS

001263450700001

Klíčová slova anglicky

Cervical cancer; Sentinel lymph node; Biopsy; Ultrastaging

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 5. 8. 2024 13:19, Mgr. Tereza Miškechová

Anotace

V originále

Objective. To report the outcome of SLN staging in the SENTIX international prospective trial of SLN biopsy in patients with cervical cancer with an intensive ultrastaging protocol and central quality control and to evaluate how the intensity of pathological assessment correlates with metastatic detection rate in SLNs. Methods. Eligible were patients with stages T1a1/LVSI+ to T1b2 (<4 cm, <= 2 cm for fertility sparing), common tumor types, no suspicious lymph nodes on imaging, and bilateral SLN detection. SLNs were examined intraoperatively , processed by an intensive protocol for ultrastaging (paraffin blocks sectioned completely in 150- mu m intervals/levels). SLNs from each site were submitted for central quality control. Results. In the SENTIX SLN study, 647 out of 733 enrolled patients underwent SLN ultrastaging, identifying 12.5% (81/647) with node positive, N1 cases. Intraoperative detection revealed metastases in 56.8% (46/81) of these cases, categorized into macrometastases (83.7%), micrometastases (26.3%) , isolated tumor cells (9.1%). Ultrastaging identified additional metastatic involvement in 43.2% (35/81) of patients, with detailed sectioning revealing metastases (MAC/MIC) at first level in 20 cases (24.7%), at levels 2 -4 in 9 cases (11.1%), and at level >= 5 in 6 cases (7.4%). Conclusion. SLN ultrastaging detects additional 43% of N1 (MAC/MIC) in patients with negative LNs by imaging and intraoperative pathological assessment. The detection rate of positive SLN correlates with the intensity (number of levels) of ultrastaging. Examination of four levels from paraffin blocks, which detects >90% of patients with N1, is a reasonable compromise for an international standard for ultrastaging.