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Cancers, Vol. 15, Pages 2052: The Risk of Recurrence in Endometrial Cancer Patients with Low-Volume Metastasis in the Sentinel Lymph Nodes: A Retrospective Multi-Institutional Study
Cancers doi: 10.3390/cancers15072052
Authors: Alessandro Buda Cristiana Paniga Salih Taskin Michael Mueller Ignacio Zapardiel Francesco Fanfani Andrea Puppo Jvan Casarin Andrea Papadia Elena De Ponti Tommaso Grassi Jessica Mauro Hasan Turan Dogan Vatansever Mete Gungor Firat Ortag Sara Imboden Virginia Garcia-Pineda Stefan Mohr Franziska Siegenthaler Stefania Perotto Fabio Landoni Fabio Ghezzi Giovanni Scambia Cagatay Taskiran Robert Fruscio
The aim of this study was to assess the impact of low-volume metastasis (LVM) on disease-free survival (DFS) in women with apparent early-stage endometrial cancer (EC) who underwent sentinel lymph node (SLN) mapping. Patients with pre-operative early-stage EC were retrospectively collected from an international collaboration including 13 referring institutions. A total of 1428 patients were included in this analysis. One hundred and eighty-six patients (13%) had lymph node involvement. Fifty-nine percent of positive SLN exhibited micrometastases, 26.9% micrometastases, and 14% isolated tumor cells. Seventeen patients with positive lymph nodes did not receive any adjuvant therapy. At a median follow-up of 33.3 months, the disease had recurred in 114 women (8%). Patients with micrometastases in the lymph nodes had a worse prognosis of disease-free survival compared to patients with negative nodes or LVM. The rate of recurrence was significantly higher for women with micrometastases than those with low-volume metastases (HR = 2.61; p = 0.01). The administration of adjuvant treatment in patients with LVM, without uterine risk factors, remains a matter of debate and requires further evaluation.
