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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2017

01-07-2017 | Gynecologic Oncology

Survival of Patients with Serous Uterine Carcinoma Undergoing Sentinel Lymph Node Mapping

Authors: Maria B. Schiavone, MD, Chiara Scelzo, MD, Celeste Straight, MD, Qin Zhou, MA, Kaled M. Alektiar, MD, Vicky Makker, MD, Robert A. Soslow, MD, Alexia Iasonos, PhD, Mario M. Leitao, MD, Nadeem R. Abu-Rustum, MD

Published in: Annals of Surgical Oncology | Issue 7/2017

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Abstract

Objective

The aim of this study was to determine progression-free survival (PFS) in patients with serous uterine carcinoma undergoing sentinel lymph node (SLN) mapping compared with patients undergoing standard lymphadenectomy.

Methods

We retrospectively reviewed all uterine cancer patients treated at our institution from 2005 to 2015. Patients were separated into two cohorts: those who underwent SLN mapping at the time of staging (SLN) and those who underwent routine lymphadenectomy (the non-SLN group). SLN mapping was performed according to institutional protocol, incorporating a surgical algorithm and pathologic ultrastaging.

Results

Overall, 248 patients were identified—153 SLN mappings and 95 routine lymphadenectomies (pelvic and/or paraaortic lymph node dissection). No significant difference in age or body mass index was observed between the groups (p = 0.08 and p = 0.9, respectively). Minimally invasive surgery was utilized in 117/153 (77%) SLN patients and 30/95 (32%) non-SLN patients (p = <0.001). Stage distribution for the SLN and non-SLN cohorts demonstrated 106/153 (69%) and 59/95 (62%) patients with stage I/II disease, respectively, and 47/153 (31%) and 36/95 (38%) patients with stage III/IV disease, respectively (p = 0.3). The median number of nodes removed was 12 (range, 1–50) in the SLN cohort versus 21 (range, 1–75) in the non-SLN cohort (p = <0.001). Adjuvant chemotherapy alone or with radiation therapy was administered in 122/153 (80%) SLN patients and 79/95 (83%) non-SLN patients; radiotherapy alone was administered in 12/153 (8%) SLN patients and 7/95 (7%) non-SLN patients (p = 0.8). At a median follow-up of 40 months, the 2-year PFS rates were 77% (95% confidence interval [CI], 68–83%) in the SLN group and 71% (95% CI, 61–79%) in the non-SLN group (p = 0.3).

Conclusions

Incorporation of the SLN mapping algorithm into the staging of uterine serous cancer is feasible and does not appear to compromise prognosis. PFS in patients with uterine serous carcinoma undergoing SLN mapping, followed by adjuvant therapy, was similar to PFS in patients undergoing standard lymphadenectomy and adjuvant therapy.
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Metadata
Title
Survival of Patients with Serous Uterine Carcinoma Undergoing Sentinel Lymph Node Mapping
Authors
Maria B. Schiavone, MD
Chiara Scelzo, MD
Celeste Straight, MD
Qin Zhou, MA
Kaled M. Alektiar, MD
Vicky Makker, MD
Robert A. Soslow, MD
Alexia Iasonos, PhD
Mario M. Leitao, MD
Nadeem R. Abu-Rustum, MD
Publication date
01-07-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 7/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5816-4

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