Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
<b>Objective:</b> To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. <b>Methods:</b> A single institutional retrospective study was carried out, which included all patien...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/6/1999 |
| _version_ | 1797564169598271488 |
|---|---|
| author | Virginia García Pineda Alicia Hernández Gutiérrez Myriam Gracia Segovia Jaime Siegrist Ridruejo María Dolores Diestro Tejeda Ignacio Zapardiel |
| author_facet | Virginia García Pineda Alicia Hernández Gutiérrez Myriam Gracia Segovia Jaime Siegrist Ridruejo María Dolores Diestro Tejeda Ignacio Zapardiel |
| author_sort | Virginia García Pineda |
| collection | DOAJ |
| description | <b>Objective:</b> To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. <b>Methods:</b> 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. <b>Results:</b> 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; <i>p</i> = 0.018), and similar results were obtained for 5-year OS (50% vs. 78.6% vs. 81.5%, respectively; <i>p</i> < 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. <b>Conclusions:</b> 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. |
| first_indexed | 2024-03-10T18:53:33Z |
| format | Article |
| id | doaj.art-ac69b879c3894a67a16cac13e91938e2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T18:53:33Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ac69b879c3894a67a16cac13e91938e22023-11-20T04:57:23ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0196199910.3390/jcm9061999Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic SignificanceVirginia García Pineda0Alicia Hernández Gutiérrez1Myriam Gracia Segovia2Jaime Siegrist Ridruejo3María Dolores Diestro Tejeda4Ignacio Zapardiel5Gynecologic Oncology Unit, La Paz University Hospital—IdiPAZ, 28046 Madrid, SpainGynecologic Oncology Unit, La Paz University Hospital—IdiPAZ, 28046 Madrid, SpainGynecologic Oncology Unit, La Paz University Hospital—IdiPAZ, 28046 Madrid, SpainGynecologic Oncology Unit, La Paz University Hospital—IdiPAZ, 28046 Madrid, SpainGynecologic Oncology Unit, La Paz University Hospital—IdiPAZ, 28046 Madrid, SpainGynecologic Oncology Unit, La Paz University Hospital—IdiPAZ, 28046 Madrid, Spain<b>Objective:</b> To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. <b>Methods:</b> 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. <b>Results:</b> 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; <i>p</i> = 0.018), and similar results were obtained for 5-year OS (50% vs. 78.6% vs. 81.5%, respectively; <i>p</i> < 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. <b>Conclusions:</b> 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.https://www.mdpi.com/2077-0383/9/6/1999low-volume metastasisultrastagingendometrial cancersentinel node biopsy |
| spellingShingle | Virginia García Pineda Alicia Hernández Gutiérrez Myriam Gracia Segovia Jaime Siegrist Ridruejo María Dolores Diestro Tejeda Ignacio Zapardiel Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance Journal of Clinical Medicine low-volume metastasis ultrastaging endometrial cancer sentinel node biopsy |
| title | Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance |
| title_full | Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance |
| title_fullStr | Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance |
| title_full_unstemmed | Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance |
| title_short | Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance |
| title_sort | low volume nodal metastasis in endometrial cancer risk factors and prognostic significance |
| topic | low-volume metastasis ultrastaging endometrial cancer sentinel node biopsy |
| url | https://www.mdpi.com/2077-0383/9/6/1999 |
| work_keys_str_mv | AT virginiagarciapineda lowvolumenodalmetastasisinendometrialcancerriskfactorsandprognosticsignificance AT aliciahernandezgutierrez lowvolumenodalmetastasisinendometrialcancerriskfactorsandprognosticsignificance AT myriamgraciasegovia lowvolumenodalmetastasisinendometrialcancerriskfactorsandprognosticsignificance AT jaimesiegristridruejo lowvolumenodalmetastasisinendometrialcancerriskfactorsandprognosticsignificance AT mariadoloresdiestrotejeda lowvolumenodalmetastasisinendometrialcancerriskfactorsandprognosticsignificance AT ignaciozapardiel lowvolumenodalmetastasisinendometrialcancerriskfactorsandprognosticsignificance |