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

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.

Basic information

Original name

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

Authors

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 8.400 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.ejca.2024.114310

UT WoS

001317295600001

Keywords in English

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

Abstract

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.

Citovat

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, 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 and David CIBULA. 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. European Journal of Cancer. London: ELSEVIER, 2024, vol. 211, November 2024, p. 1-6. ISSN 0959-8049. Available from: https://dx.doi.org/10.1016/j.ejca.2024.114310.

@article{2439073,
   author = {Bizzarri, Nicolo and Querleu, Denis and Ramirez, Pedro T and Dostalek, Lukas and van Lonkhuijzen, Luc R C W and Giannarelli, Diana and Lopez, Aldo and Salehi, Sahar and Ayhan, Ali and Kim, Sarah H and Ortiz, David Isla and Klat, Jaroslav and Landoni, Fabio and Pareja, Rene and Manchanda, Ranjit and Kostun, Jan and Meydanli, Mehmet M and Odetto, Diego and Laky, Rene and Zapardiel, Ignacio and Weinberger, Vít and Ricardo, Dos Reis and Anchora, Luigi Pedone and Amaro, Karina and Akilli, Huseyin and AbuandRustum, Nadeem R and SalcedoandHernandez, Rosa A and Javurkova, Veronika and Mom, Constantijne H and Falconer, Henrik and Scambia, Giovanni and Cibula, David},
   article_location = {London},
   article_number = {November 2024},
   doi = {http://dx.doi.org/10.1016/j.ejca.2024.114310},
   keywords = {Cervical cancer; Sentinel lymph node; Lymphadenectomy; Survival; Recurrence; Ultrastaging},
   language = {eng},
   issn = {0959-8049},
   journal = {European Journal of Cancer},
   title = {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},
   url = {https://www.sciencedirect.com/science/article/pii/S0959804924009663?via%3Dihub},
   volume = {211},
   year = {2024}
}

TY  - JOUR
ID  - 2439073
AU  - Bizzarri, Nicolo - Querleu, Denis - Ramirez, Pedro T - Dostalek, Lukas - van Lonkhuijzen, Luc R C W - Giannarelli, Diana - Lopez, Aldo - Salehi, Sahar - Ayhan, Ali - Kim, Sarah H - Ortiz, David Isla - Klat, Jaroslav - Landoni, Fabio - Pareja, Rene - Manchanda, Ranjit - Kostun, Jan - Meydanli, Mehmet M - Odetto, Diego - Laky, Rene - Zapardiel, Ignacio - Weinberger, Vít - Ricardo, Dos Reis - Anchora, Luigi Pedone - Amaro, Karina - Akilli, Huseyin - Abu-Rustum, Nadeem R - Salcedo-Hernandez, Rosa A - Javurkova, Veronika - Mom, Constantijne H - Falconer, Henrik - Scambia, Giovanni - Cibula, David
PY  - 2024
TI  - 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
JF  - European Journal of Cancer
VL  - 211
IS  - November 2024
SP  - 1-6
EP  - 1-6
PB  - ELSEVIER
SN  - 09598049
KW  - Cervical cancer
KW  - Sentinel lymph node
KW  - Lymphadenectomy
KW  - Survival
KW  - Recurrence
KW  - Ultrastaging
UR  - https://www.sciencedirect.com/science/article/pii/S0959804924009663?via%3Dihub
N2  - 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.
ER  -

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, 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 and David CIBULA. 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. \textit{European Journal of Cancer}. London: ELSEVIER, 2024, vol.~211, November 2024, p.~1-6. ISSN~0959-8049. Available from: https://dx.doi.org/10.1016/j.ejca.2024.114310.

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