Background: Sentinel lymph node (SLN) biopsy is recommended over systematic lymphadenectomy in early-stage endometrial cancer due to its lower morbidity and comparable detection rate. The objective of this study was to identify clinical factors associated with unsuccessful mapping. Methods: Between April 2020 and June 2024, 120 patients over the age of 18 and diagnosed with early-stage endometrial cancer were enrolled in this prospective study at a single institution. Demographic, clinicopathologic, and treatment data were collected and analyzed using descriptive statistics. Univariate and multiple linear regressions were performed to identify predictors of failed mapping. Results: The mean age of the patient cohort was 62.5 years (range 33 to 83), and the mean body mass index (BMI) was 32 kg/m2(range 18 to 50). Patients underwent intracervical injections with methylene blue (MB), indocyanine green (ICG), or a combination of both tracers, with 40 patients in each group. A total of 108 patients (90.0%) were diagnosed with endometrioid carcinoma and 12 (10.0%) with non-endometrioid cancers. Additionally, 110 patients (91.7%) were diagnosed in early stages of the disease. The overall SLN detection rate was 73.4%, with bilateral detection at 49.2% and unilateral detection at 24.2%. Univariate analysis showed that older age (p< 0.001), menopause (p= 0.001), the use of MB as the sole tracer (p= 0.006), a shorter tumor-to-serosa distance (p= 0.048), and bulky lymph nodes (p= 0.18) were associated with unsuccessful mapping. Multiple linear regression model analysis identified age (p= 0.007), tracer type (p= 0.013), and enlarged lymph nodes (p= 0.013) as independent predictors of SLN mapping failure. Conclusions: Advanced age, tracer type, and intraoperative detection of enlarged lymph nodes were identified as independent risk factors for unsuccessful mapping in patients undergoing laparoscopic SLN mapping.
背景：在早期子宫内膜癌中，前哨淋巴结活检因其较低的并发症发生率和相当的检出率，被推荐替代系统性淋巴结清扫术。本研究旨在识别与前哨淋巴结示踪失败相关的临床因素。方法：2020年4月至2024年6月期间，在一家单一机构开展的前瞻性研究中，纳入了120名年龄超过18岁且诊断为早期子宫内膜癌的患者。收集了人口统计学、临床病理学及治疗数据，并采用描述性统计学进行分析。通过单因素及多元线性回归分析，识别示踪失败的预测因素。结果：患者队列的平均年龄为62.5岁（范围33至83岁），平均体重指数为32 kg/m²（范围18至50）。患者接受了宫颈注射亚甲蓝、吲哚菁绿或两种示踪剂联合注射，每组各40例患者。共有108例患者（90.0%）被诊断为子宫内膜样癌，12例（10.0%）为非子宫内膜样癌。此外，110例患者（91.7%）在疾病早期阶段确诊。总体前哨淋巴结检出率为73.4%，其中双侧检出率为49.2%，单侧检出率为24.2%。单因素分析显示，年龄较大（p<0.001）、绝经状态（p=0.001）、单独使用亚甲蓝作为示踪剂（p=0.006）、肿瘤至浆膜层距离较短（p=0.048）以及淋巴结肿大（p=0.18）与示踪失败相关。多元线性回归模型分析确定年龄（p=0.007）、示踪剂类型（p=0.013）和淋巴结肿大（p=0.013）为前哨淋巴结示踪失败的独立预测因素。结论：高龄、示踪剂类型以及术中发现淋巴结肿大被确定为接受腹腔镜前哨淋巴结示踪患者示踪失败的独立危险因素。
肿瘤(癌症)患者之家