Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance

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ID: 110335
2020
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Abstract
Objective: To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. Methods: A single institutional retrospective study was carried out, which included all patients with endometrial cancer who underwent surgical treatment between January 2007 and December 2016. We analyzed the progression-free survival (PFS) and overall survival (OS) of all patients after sentinel node biopsy and full nodal surgical staging according to their final pathological nodal status, focusing on the impact of the size of nodal metastasis. Results: A total of 270 patients were operated on during the study period; among them, 230 (85.2%) patients underwent nodal staging. On final pathology, 196 (85.2%) patients had negative lymph nodes; low-volume metastasis (LVM) was present in 14 (6.1%) patients: 6 (2.6%) patients had isolated tumor cells (ITCs) and 8 (3.5%) patients presented just micrometastasis; additionally, 20 (8.7%) patients presented macrometastasis. After a median (range) follow-up of 60 (0–146) months, patients with macrometastasis showed a significantly worse PFS compared to LVM and node-negative patients (61.1% vs. 71.4% vs. 83.2%, respectively; p = 0.018), and similar results were obtained for 5-year OS (50% vs. 78.6% vs. 81.5%, respectively; p < 0.001). Half of the patients presenting LVM did not receive adjuvant treatment. Moreover, LVM had a moderate nonsignificant decrease in 5-year PFS compared to node-negative patients. Conclusions: Patients with endometrial cancer and low-volume nodal metastasis demonstrated a better prognosis than those presenting macrometastasis. Low-volume metastasis did not show worse oncological outcomes than node-negative patients, although there was a slight decrease in progression-free survival.
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Authors Virginia García Pineda;Alicia Hernández Gutiérrez;Myriam Gracia Segovia;Jaime Siegrist Ridruejo;María Dolores Diestro Tejeda;Ignacio Zapardiel;García Pineda, Virginia;Hernández Gutiérrez, Alicia;Gracia Segovia, Myriam;Siegrist Ridruejo, Jaime;Diestro Tejeda, María Dolores;Zapardiel, Ignacio;
Journal journal of clinical medicine
Year 2020
DOI
10.3390/jcm9061999
URL
https://doi.org/10.3390/jcm9061999
Keywords
endometrial cancer low-volume metastasis ultrastaging sentinel node biopsy National Center for Biotechnology Information NCBI NLM MEDLINE pubmed abstract nih national institutes of health national library of medicine pmid:32630498 pmc7356149 doi:10.3390/jcm9061999 virginia garcía pineda alicia hernández gutiérrez ignacio zapardiel

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