J 2024

Survival associated with the use of sentinel lymph node in addition to lymphadenectomy in early-stage cervical cancer treated with surgery alone: A sub-analysis of the Surveillance in Cervical CANcer (SCCAN) collaborative study

BIZZARRI, Nicolo, Denis QUERLEU, Pedro T RAMIREZ, Lukas DOSTALEK, Luc R C W VAN LONKHUIJZEN et. al.

Základní údaje

Originální název

Survival associated with the use of sentinel lymph node in addition to lymphadenectomy in early-stage cervical cancer treated with surgery alone: A sub-analysis of the Surveillance in Cervical CANcer (SCCAN) collaborative study

Autoři

BIZZARRI, Nicolo, Denis QUERLEU, Pedro T RAMIREZ, Lukas DOSTALEK, Luc R C W VAN LONKHUIJZEN, Diana GIANNARELLI, Aldo LOPEZ, Sahar SALEHI, Ali AYHAN, Sarah H KIM, David Isla ORTIZ, Jaroslav KLAT, Fabio LANDONI, Rene PAREJA, Ranjit MANCHANDA, Jan KOSTUN, Mehmet M MEYDANLI, Diego ODETTO, Rene LAKY, Ignacio ZAPARDIEL, Vít WEINBERGER (203 Česká republika, domácí), Dos Reis RICARDO, Luigi Pedone ANCHORA, Karina AMARO, Huseyin AKILLI, Nadeem R ABU-RUSTUM, Rosa A SALCEDO-HERNANDEZ, Veronika JAVURKOVA, Constantijne H MOM, Henrik FALCONER, Giovanni SCAMBIA a David CIBULA (203 Česká republika)

Vydání

European Journal of Cancer, London, ELSEVIER, 2024, 0959-8049

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 8.400 v roce 2022

Organizační jednotka

Lékařská fakulta

UT WoS

001317295600001

Klíčová slova anglicky

Cervical cancer; Sentinel lymph node; Lymphadenectomy; Survival; Recurrence; Ultrastaging

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 1. 10. 2024 10:23, Mgr. Tereza Miškechová

Anotace

V originále

Aim: The aim of this study was to assess whether the use of sentinel lymph node (SLN) in addition to lymphadenectomy was associated with survival benefit in patients with early-stage cervical cancer. Methods: International, multicenter, retrospective study. Inclusion criteria: cervical cancer treated between 01/2007 and 12/2016 by surgery only; squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma, FIGO 2009 stage IB1-IIA2, negative surgical margins, and laparotomy approach. Patients undergoing neo-adjuvant and/or adjuvant treatment and/or with positive para-aortic lymph nodes, were excluded. Women with positive pelvic nodes who refused adjuvant treatment, were included. Lymph node assessment was performed by SLN (with ultrastaging protocol) plus pelvic lymphadenectomy ('SLN' group) or pelvic lymphadenectomy alone ('non-SLN' group). Results: 1083 patients were included: 300 (27.7 %) in SLN and 783 (72.3 %) in non-SLN group. 77 (7.1 %) patients had recurrence (N = 11, 3.7 % SLN versus N = 66, 8.4 % non-SLN, p = 0.005) and 34 (3.1 %) (N = 4, 1.3 % SLN versus N = 30, 3.8 % non-SLN, p = 0.033) died. SLN group had better 5-year disease-free survival (DFS) (96.0 %,95 %CI:93.5-98.5 versus 92.0 %,95 %CI:90.0-94.0; p = 0.024). No 5-year overall survival (OS) difference was shown (98.4 %,95 %CI:96.8-99.9 versus 96.8 %,95 %CI:95.4-98.2; p = 0.160). SLN biopsy and lower stage were independent factors associated with improved DFS (HR:0.505,95 %CI:0.266-0.959, p = 0.037 and HR:2.703,95 %CI:1.389-5.261, p = 0.003, respectively). Incidence of pelvic central recurrences was higher in the non-SLN group (1.7 % versus 4.5 %, p = 0.039). Conclusion: Adding SLN biopsy to pelvic lymphadenectomy was associated with lower recurrence and death rate and improved 5-year DFS. This might be explained by the lower rate of missed nodal metastasis thanks to the use of SLN ultrastaging. SLN biopsy should be recommended in patients with early-stage cervical cancer.