文章：

机器人辅助与腹腔镜前哨淋巴结活检在子宫内膜癌中的肿瘤学结果

Oncologic Outcome of Robotic-Assisted and Laparoscopic Sentinel Node Biopsy in Endometrial Cancer

原文发布日期：18 December 2023

DOI: 10.3390/cancers15245894

类型: Article

开放获取: 是

英文摘要：

Background: Recently, sentinel lymph node biopsy (SLNB) has been introduced in the surgical staging of endometrial cancer as an alternative to systematic lymph node dissection (LND). However, the survival impact of SLNB is not yet well characterised. Methods: We performed a retrospective study of 419 patients with endometrial cancer treated with SLNB alone or with pelvic and para-aortic LND. For SLNB mapping, indocyanine green was used. Results: Median follow-up was 66 months. After exclusions, 337 patients were eligible for analysis. Of them, 150 underwent SLNB and 187 LND. During the follow-up time, 27 (24.7%) of the 150 who underwent SLNB and 54 (28.9%) of the 187 who underwent LND were diagnosed with recurrent disease (p= 0.459). The estimated 5-year disease-free survival (DFS) rate was 76.7% and 72.2% for patients in the SLNB and LND group, respectively (p= 0.419). The 5-year overall survival (OS) rates were 80.7% and 77.0% in the SLNB and LND group, respectively (p= 0.895). Survival rates were similar in both groups independent of lymph node status. Multivariable analysis confirmed that the staging approach was not associated with oncological outcome. For patients without lymph node metastases, patient outcome was worsened by advanced tumour stage and non-endometrioid tumour histology. In the group of patients with confirmed lymph node metastases, advanced tumour stage and inadequate adjuvant treatment significantly reduced DFS and OS. Conclusion: Our data suggested that SLNB did not compromise the oncological outcome of patients with endometrial cancer compared to LND.

摘要翻译： 

背景：近年来，前哨淋巴结活检（SLNB）已被引入子宫内膜癌的手术分期中，作为系统性淋巴结清扫术（LND）的替代方案。然而，SLNB对生存的影响尚未得到充分阐明。方法：我们对419例子宫内膜癌患者进行了回顾性研究，这些患者接受了单纯SLNB或联合盆腔及腹主动脉旁LND治疗。SLNB定位采用吲哚菁绿示踪。结果：中位随访时间为66个月。排除后，337例患者符合分析条件。其中，150例接受了SLNB，187例接受了LND。随访期间，150例接受SLNB的患者中有27例（24.7%），187例接受LND的患者中有54例（28.9%）被诊断为疾病复发（p=0.459）。SLNB组和LND组患者的估计5年无病生存率分别为76.7%和72.2%（p=0.419）。SLNB组和LND组的5年总生存率分别为80.7%和77.0%（p=0.895）。无论淋巴结状态如何，两组的生存率均相似。多变量分析证实，分期方法与肿瘤学结局无关。对于无淋巴结转移的患者，晚期肿瘤分期和非子宫内膜样肿瘤组织学类型会恶化患者结局。在确诊淋巴结转移的患者组中，晚期肿瘤分期和不充分的辅助治疗显著降低了无病生存率和总生存率。结论：我们的数据表明，与LND相比，SLNB并未损害子宫内膜癌患者的肿瘤学结局。

原文链接：

Oncologic Outcome of Robotic-Assisted and Laparoscopic Sentinel Node Biopsy in Endometrial Cancer