Conclusion
Our data demonstrates that high SLN detection rates can be achieved by
gynecologic oncologists treating women with endometrial cancer at
non-specialty surgical institutions. Optimization of provider technique
and expertise is critical in order to meet defined standards of SLN
detection accuracy. Once individual surgeons demonstrate proficiency in
SLN mapping and detection, based on our data, it would seem reasonable
to recommend SLN mapping and biopsy as standard of care for the
treatment and management of uterine endometrial cancer across all
institutions.
Declarations:
The authors have no financial, personal, political, intellectual or
religious interests to disclose.
Contribution to authorship:
Sarah Werner is the main investigator- including planning and compiling
data and writing abstract and manuscript. Therese Gadomski provided
assistance with project planning, data collection and manuscript
editing. Drs. Pereira and Villella are the primary investigators for
this project and are involved in conception, planning and manuscript
editing. Tung Ming Leung contributed with data analysis.
Ethics: IRB approval for this retrospective analysis did not include
approval from ethics committee.
Funding: Authors have no external funding to disclose for the completion
of this project.
References
- R.L Siegal, K.D Miller, A. Jermal. Cancer Statistics, 2020. CA Cancer
J Clin. 77 (2020) 7-30.
- Smith Anna J, Fader Amanda, Tanner Edward. Sentinel lymph node
assessment in endometrial cancer: a systematic review and
meta-analysis. American Journal Obstetrics and Gynecology 2017;
459-476
- NCCN, Guidelines Version 1.2014, Endometrial Carcinoma, 2014 (Accessed
April 4, 2020).
- Society of Gynecologic Oncology. (2015) Clinical Practice
Statement: The Role of Sentinel Lymph Node Mapping in Endometrial
Cancer. Chicago, IL. 5. Lyman GH, Giuliano AE, Somerfield MR, et al.
American Society of Clinical Oncology guideline recommendations for
sentinel lymph node biopsy in early-stage breast cancer. J. Clin.
Oncol. 2005; 23: 7703-7720
- Kang, S., Yoo, H. J., Hwang, J. H., Lim, M., Seo, S., & Park, S.
(2011). Sentinel lymph node biopsy in endometrial cancer:
Meta-analysis of 26 studies. Gynecologic Oncology,123 (3), 522-527. doi:10.1016/j.ygyno.2011.08.034
- Khoury-Collado F, Glaser GE, Zivanovic O, et al. Improving sentinel
lymph node detection rates in endometrial cancer: How many cases are
needed? Gynecol. Oncol. 2009; 115: 453-455.
- Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of
Clinical Oncology guideline recommendations for sentinel lymph node
biopsy in early-stage breast cancer. J. Clin. Oncol. 2005; 23:
7703-7720.
- Benedetti Panici P, Basile S, Maneschi F, et al. Systematic pelvic
lymphadenectomy vs. no lymphadenectomy in early-stage endometrial
carcinoma: randomized clinical trial. J. Natl. Cancer Inst. 2008; 100:
1707-1716.
- Kitchener H, Swart AM, Qian Q, et al. Efficacy of systematic pelvic
lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomized
study. Lancet 2009; 373: 125-136.
- Holloway R, Gupta S, Stavitzski N et al. Sentinel lymph node mapping
with stagging lymphadenectomy for patients with endometrial cancer
increases the detection of metastasis. Gynecol. Oncol. 2016; 141:
206-210
- Benedetti Panici P, Basile S, Maneschi F, et al. Systematic pelvic
lymphadenectomy vs. no lymphadenectomy in early-stage endometrial
carcinoma: randomized clinical trial. J. Natl. Cancer Inst. 2008; 100:
1707-1716.
- How J, Gauthier C, Abitbol J, et al. Impact of sentinel lymph node
mapping on recurrence patterns in endometrial cancer. Gynecol. Oncol.
2017; 144: 503-509.
- Dowdy SC, Mariani A. Lymphadenectomy in endometrial cancer: when, not
if. Lancet 2010; 375: 1138-1140.
- Tanner EJ, Sinno AK, Stone RL, et al. Factors associated with
sucessful bilateral lymph node mapping in endometrial cancer. Gynecol.
Oncol. 2015; 138: 542-547