دورية أكاديمية
Concurrent endometrial cancer in atypical endometrial hyperplasia and the role of sentinel lymph nodes: clinical insights from a multicenter experience.
| العنوان: | Concurrent endometrial cancer in atypical endometrial hyperplasia and the role of sentinel lymph nodes: clinical insights from a multicenter experience. |
|---|---|
| المؤلفون: | Rosati A; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy dott.andrearosati89@gmail.com.; Università Cattolica del Sacro Cuore, Rome, Italy., Vargiu V; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy., Capozzi VA; Department of Medicine and Surgery, University of Parma, Parma, Italy., Giannarelli D; Facility of Epidemiology and Biostatistics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy., Palmieri E; Università Cattolica del Sacro Cuore, Rome, Italy., Baroni A; Università Cattolica del Sacro Cuore, Rome, Italy., Perrone E; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy., Berretta R; Department of Medicine and Surgery, University of Parma, Parma, Italy., Cosentino F; Department of Medicine and Health Sciences 'Vincenzo Tiberio', Università degli Studi del Molise, Campobasso, Molise, Italy., Scambia G; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.; Università Cattolica del Sacro Cuore, Rome, Italy., Fanfani F; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.; Università Cattolica del Sacro Cuore, Rome, Italy. |
| المصدر: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2024 Jul 01; Vol. 34 (7), pp. 1011-1019. Date of Electronic Publication: 2024 Jul 01. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Electronic Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [London] : BMJ Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991- |
| مواضيع طبية MeSH: | Endometrial Neoplasms*/pathology , Endometrial Neoplasms*/surgery , Endometrial Hyperplasia*/pathology , Endometrial Hyperplasia*/surgery , Endometrial Hyperplasia*/epidemiology , Sentinel Lymph Node Biopsy* , Sentinel Lymph Node*/pathology , Sentinel Lymph Node*/surgery , Hysterectomy*, Humans ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Adult ; Salpingo-oophorectomy |
| مستخلص: | Objective: This study aimed to evaluate the prevalence of concurrent endometrial cancer in patients pre-operatively diagnosed with atypical endometrial hyperplasia undergoing hysterectomy. Additionally, we assessed the occurrence of high to intermediate-risk and high-risk tumors according to the ESGO-ESTRO-ESP classification. The study also compared surgical outcomes and complications between patients undergoing simple hysterectomy and those undergoing hysterectomy with sentinel lymph node biopsy. Methods: In this multicenter retrospective study, patients with a pre-operative diagnosis of atypical endometrial hyperplasia were identified and divided into two groups: Group 1, which included patients treated with total hysterectomy with or without bilateral salpingo-oophorectomy, and Group 2, where sentinel lymph node biopsy was incorporated into the standard surgical treatment. Results: Among 460 patients with atypical endometrial hyperplasia, 192 received standard surgical management (Group 1) and 268 underwent sentinel lymph node biopsy (Group 2). A total of 47.2% (95% CI 42.6% to 51.7%) of patients were upgraded to endometrial cancer on final histopathological examination. High to intermediate-risk and high-risk tumors constituted 12.3% and 9.2% in Group 2 and 7.4% and 3.7% in Group 1. Lymph node metastases were identified in 7.6% of patients with concurrent endometrial cancer who underwent nodal assessment with at least unilateral mapping. Of the 12 sentinel lymph node metastases, 75.0% were micrometastases, 16.7% macrometastases, and 8.3% isolated tumor cells. No significant differences were found in estimated blood loss, operative time, and intra-operative and post-operative complications between the two groups. The rate of patients undergoing sentinel lymph node biopsy doubled every 2 years (OR 2.010, p<0.001), reaching 79.1% in the last 2 years. Conclusion: This study found a prevalence of concurrent endometrial cancer of 47.2%, and sentinel lymph node biopsy provided prognostic and therapeutic information in 60.8% of cases. It also allowed for the adjustment of adjuvant therapy in 12.3% of high to intermediate-risk patients without increasing operative time or complication rates. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| فهرسة مساهمة: | Keywords: Endometrial Hyperplasia; Endometrial Neoplasms; Sentinel Lymph Node |
| تواريخ الأحداث: | Date Created: 20240302 Date Completed: 20240701 Latest Revision: 20240701 |
| رمز التحديث: | 20240702 |
| DOI: | 10.1136/ijgc-2023-005202 |
| PMID: | 38431287 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder كن أول من يترك تعليقا!