Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study
The aim of this study is to define the role of preoperative positron emission tomography/computed tomography (PET/CT) scan and sentinel lymph node (SLN) biopsy for nodal metastasis detection in Endometrial Cancer (EC) patients. From January 2014 to August 2016 patients affected by EC scheduled for s...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-07-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2019.1675822 |
| _version_ | 1827817351362379776 |
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| author | Innocenza Palaia Violante Di Donato Angela Musella Anna Di Pinto Giusi Santangelo Giuliano Petriglia Pierluigi Benedetti Panici |
| author_facet | Innocenza Palaia Violante Di Donato Angela Musella Anna Di Pinto Giusi Santangelo Giuliano Petriglia Pierluigi Benedetti Panici |
| author_sort | Innocenza Palaia |
| collection | DOAJ |
| description | The aim of this study is to define the role of preoperative positron emission tomography/computed tomography (PET/CT) scan and sentinel lymph node (SLN) biopsy for nodal metastasis detection in Endometrial Cancer (EC) patients. From January 2014 to August 2016 patients affected by EC scheduled for surgery underwent PET/CT scan and SLN mapping with indocyanine-green. Patients with suspicious lymph nodes at FDG-PET/CT underwent selective pelvic lymphadenectomy. In case of undetectable SLN, no further lymphadenectomy was performed if PET/CT scan was negative. Basic descriptive statistics were used to describe outcomes. A total of 83 patients were enrolled in the study. PET/CT scan was suggestive of nodal involvement in 15 patients. SLN were detected bilaterally in 78% of patients. Detection rate was influenced by patients’ BMI and surgical learning curve. Five patients were node-positive: all of these had hypermetabolic nodes on PET/CT scan; in one patient SLN was not detected. Ten out of 15 patients with suspicious nodes on PET/CT scan were node-negative. After a median follow up of 24 months all patients are alive. Four patients experienced recurrent disease. No nodal relapse was recorded. Lymphatic mapping with sentinel node biopsy is able to reduce morbidity associated with pelvic lymphadenectomy. Sentinel node assessment is a feasible and appealing procedure and should be performed in a specialized center. Detection rate strongly improves with learning curve, while is reduced in morbidly obese patients. PET/CT scan shows high sensitivity but moderate specificity for nodal metastasis and may help to avoid nodal dissection in patients with sentinel node mapping failure. |
| first_indexed | 2024-03-12T00:33:03Z |
| format | Article |
| id | doaj.art-62b4d93756894b6bbea48271609571a3 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:33:03Z |
| publishDate | 2021-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-62b4d93756894b6bbea48271609571a32023-09-15T10:07:31ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-07-0134667267610.1080/08941939.2019.16758221675822Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective StudyInnocenza Palaia0Violante Di Donato1Angela Musella2Anna Di Pinto3Giusi Santangelo4Giuliano Petriglia5Pierluigi Benedetti Panici6Department of Obstetrics and Gynecology, Sapienza University of RomeDepartment of Obstetrics and Gynecology, Sapienza University of RomeDepartment of Obstetrics and Gynecology, Sapienza University of RomeDepartment of Obstetrics and Gynecology, Sapienza University of RomeDepartment of Obstetrics and Gynecology, Sapienza University of RomeDepartment of Obstetrics and Gynecology, Sapienza University of RomeDepartment of Obstetrics and Gynecology, Sapienza University of RomeThe aim of this study is to define the role of preoperative positron emission tomography/computed tomography (PET/CT) scan and sentinel lymph node (SLN) biopsy for nodal metastasis detection in Endometrial Cancer (EC) patients. From January 2014 to August 2016 patients affected by EC scheduled for surgery underwent PET/CT scan and SLN mapping with indocyanine-green. Patients with suspicious lymph nodes at FDG-PET/CT underwent selective pelvic lymphadenectomy. In case of undetectable SLN, no further lymphadenectomy was performed if PET/CT scan was negative. Basic descriptive statistics were used to describe outcomes. A total of 83 patients were enrolled in the study. PET/CT scan was suggestive of nodal involvement in 15 patients. SLN were detected bilaterally in 78% of patients. Detection rate was influenced by patients’ BMI and surgical learning curve. Five patients were node-positive: all of these had hypermetabolic nodes on PET/CT scan; in one patient SLN was not detected. Ten out of 15 patients with suspicious nodes on PET/CT scan were node-negative. After a median follow up of 24 months all patients are alive. Four patients experienced recurrent disease. No nodal relapse was recorded. Lymphatic mapping with sentinel node biopsy is able to reduce morbidity associated with pelvic lymphadenectomy. Sentinel node assessment is a feasible and appealing procedure and should be performed in a specialized center. Detection rate strongly improves with learning curve, while is reduced in morbidly obese patients. PET/CT scan shows high sensitivity but moderate specificity for nodal metastasis and may help to avoid nodal dissection in patients with sentinel node mapping failure.http://dx.doi.org/10.1080/08941939.2019.1675822abdominal surgerycancerendoscopyphysiologysurgical techniquemedical devices |
| spellingShingle | Innocenza Palaia Violante Di Donato Angela Musella Anna Di Pinto Giusi Santangelo Giuliano Petriglia Pierluigi Benedetti Panici Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study Journal of Investigative Surgery abdominal surgery cancer endoscopy physiology surgical technique medical devices |
| title | Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study |
| title_full | Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study |
| title_fullStr | Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study |
| title_full_unstemmed | Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study |
| title_short | Value of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Sentinel Lymph Node Biopsy in Endometrial Cancer Patients: A Prospective Study |
| title_sort | value of fluorodeoxyglucose positron emission tomography computed tomography and sentinel lymph node biopsy in endometrial cancer patients a prospective study |
| topic | abdominal surgery cancer endoscopy physiology surgical technique medical devices |
| url | http://dx.doi.org/10.1080/08941939.2019.1675822 |
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