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
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.