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
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.