Department of Gynecologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France.
Curr Oncol Rep. 2013 Dec;15(6):559-65. doi: 10.1007/s11912-013-0345-1.
Lymph node status is a major prognostic factor in endometrial cancer (EC). Sentinel lymph node (SLN) biopsy has been reported in EC for more than 15 years but has not yet been incorporated as a standard-of-care procedure in EC. Complex uterine drainage, the various modalities of tracer injection, and the lack of large prospective series may explain this situation. In this review, we report an SLN detection rate of 81.7 %, a 10.9 % rate of metastatic SLN involvement, and a false-negative rate of 12.3 % in the main clinical trials. Thirty-five percent of SLN metastases were low-volume disease (micrometastases or isolated tumor cells). These data raise the question of the clinical significance of low-volume disease in EC. SLN biopsy could allow upstaging in supposedly low- or intermediate-risk patients in whom adjuvant therapy could be omitted. Further studies are required to precise the interest on the survival of this procedure in this subset of patients.
淋巴结状态是子宫内膜癌（EC）的主要预后因素。前哨淋巴结（SLN）活检在 EC 中已经报道了 15 年以上，但尚未纳入 EC 的标准治疗程序。复杂的子宫引流、示踪剂注射的各种方式以及缺乏大型前瞻性系列可能解释了这种情况。在这篇综述中，我们报告了主要临床试验中的 SLN 检测率为 81.7%，转移性 SLN 受累率为 10.9%，假阴性率为 12.3%。35%的 SLN 转移为低容量疾病（微转移或孤立肿瘤细胞）。这些数据提出了低容量疾病在 EC 中的临床意义问题。SLN 活检可以使原本低风险或中风险的患者升级，这些患者可以省略辅助治疗。需要进一步的研究来明确该手术在这部分患者生存中的意义。
