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

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.

Basic information

Original name

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

Authors

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

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.700 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.ygyno.2024.06.015

UT WoS

001263450700001

Keywords in English

Cervical cancer; Sentinel lymph node; Biopsy; Ultrastaging

Abstract

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.

Citovat

KOCIAN, Roman, Christhardt KOHLER, Sylva BAJSOVA, Jiří JARKOVSKÝ, Ignacio ZAPARDIEL, Di Martino GIAMPAOLO, Luc VAN LONKHUIJZEN, Borek SEHNAL, Octavio Arencibia SANCHEZ, Blanca GIL-IBANEZ, Fabio MARTINELLI, Jiri PRESL, Luboš MINÁŘ, Radovan PILKA, Peter KASCAK, Pavel HAVELKA, Martin MICHAL, Toon VAN GORP, Kristyna NEMEJCOVA, Pavel DUNDR and David CIBULA. Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer. Gynecologic oncology. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2024, vol. 188, September 2024, p. 83-89. ISSN 0090-8258. Available from: https://dx.doi.org/10.1016/j.ygyno.2024.06.015.

@article{2421703,
   author = {Kocian, Roman and Kohler, Christhardt and Bajsova, Sylva and Jarkovský, Jiří and Zapardiel, Ignacio and Giampaolo, Di Martino and van Lonkhuijzen, Luc and Sehnal, Borek and Sanchez, Octavio Arencibia and GilandIbanez, Blanca and Martinelli, Fabio and Presl, Jiri and Minář, Luboš and Pilka, Radovan and Kascak, Peter and Havelka, Pavel and Michal, Martin and van Gorp, Toon and Nemejcova, Kristyna and Dundr, Pavel and Cibula, David},
   article_location = {SAN DIEGO},
   article_number = {September 2024},
   doi = {http://dx.doi.org/10.1016/j.ygyno.2024.06.015},
   keywords = {Cervical cancer; Sentinel lymph node; Biopsy; Ultrastaging},
   language = {eng},
   issn = {0090-8258},
   journal = {Gynecologic oncology},
   title = {Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer},
   url = {https://www.sciencedirect.com/science/article/pii/S0090825824003305?via%3Dihub},
   volume = {188},
   year = {2024}
}

TY  - JOUR
ID  - 2421703
AU  - Kocian, Roman - Kohler, Christhardt - Bajsova, Sylva - Jarkovský, Jiří - Zapardiel, Ignacio - Giampaolo, Di Martino - van Lonkhuijzen, Luc - Sehnal, Borek - Sanchez, Octavio Arencibia - Gil-Ibanez, Blanca - Martinelli, Fabio - Presl, Jiri - Minář, Luboš - Pilka, Radovan - Kascak, Peter - Havelka, Pavel - Michal, Martin - van Gorp, Toon - Nemejcova, Kristyna - Dundr, Pavel - Cibula, David
PY  - 2024
TI  - Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer
JF  - Gynecologic oncology
VL  - 188
IS  - September 2024
SP  - 83-89
EP  - 83-89
PB  - ACADEMIC PRESS INC ELSEVIER SCIENCE
SN  - 00908258
KW  - Cervical cancer
KW  - Sentinel lymph node
KW  - Biopsy
KW  - Ultrastaging
UR  - https://www.sciencedirect.com/science/article/pii/S0090825824003305?via%3Dihub
N2  - 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.
ER  -

KOCIAN, Roman, Christhardt KOHLER, Sylva BAJSOVA, Jiří JARKOVSKÝ, Ignacio ZAPARDIEL, Di Martino GIAMPAOLO, Luc VAN LONKHUIJZEN, Borek SEHNAL, Octavio Arencibia SANCHEZ, Blanca GIL-IBANEZ, Fabio MARTINELLI, Jiri PRESL, Luboš MINÁŘ, Radovan PILKA, Peter KASCAK, Pavel HAVELKA, Martin MICHAL, Toon VAN GORP, Kristyna NEMEJCOVA, Pavel DUNDR and David CIBULA. Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer. \textit{Gynecologic oncology}. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2024, vol.~188, September 2024, p.~83-89. ISSN~0090-8258. Available from: https://dx.doi.org/10.1016/j.ygyno.2024.06.015.

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