Sentinel node biopsy upstages patients with presumed low- and intermediate-risk endometrial cancer: results of a multicenter study.
BACKGROUND
There is some controversy about the relevance of lymphadenectomy in patients with early stage endometrial cancer. The aim of this study was to evaluate the contribution of sentinel lymph node (SLN) biopsy in staging patients with presumed low- and intermediate-risk endometrial cancer.


METHODS
This retrospective multicenter study was conducted from July 2007 to December 2011 including 103 patients with presumed low- or intermediate-risk endometrial cancer who had undergone SLN biopsy. Concordance between preoperative staging and definitive histology as well as contribution of SLN biopsy and ultrastaging to upstage patients were assessed.


RESULTS
SLNs were detected in 89 patients (86.4 %), 56 (62.9 %) of whom had presumed low-risk and 33 (37.1 %) intermediate-risk endometrial cancer. Of the 89 patients, 14 (15.7 %) had positive SLNs. Twelve (21.4 %) of the 56 patients with presumed low-risk disease were upstaged by definitive histology, among whom 3 (25 %) had pelvic positive SLNs. Seven (21.2 %) of the 33 patients with intermediate-risk disease were upstaged by definitive histology, 1 (14.3 %) of whom had positive SLNs. Ultrastaging detected metastases undiagnosed by conventional histology in 6 (42.8 %) of 14 of patients with positive SLNs.


CONCLUSIONS
SLN biopsy associated with ultrastaging is relevant to stage low- or intermediate-risk endometrial cancer and could help guide adjuvant therapies.
Tenon University Hospital, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France. marcos.ballester@tnn.aphp.fr
Marcos
M
Ballester
Iptissem
I
Naoura
Elisabeth
E
Chéreau
Julien
J
Seror
Anne-Sophie
AS
Bats
Alexandre
A
Bricou
Emile
E
Daraï
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy