Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy.
Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, USA.
Gynecol Oncol. 2019 Jun;153(3):670-675. doi: 10.1016/j.ygyno.2019.02.027. Epub 2019 Mar 1.
Nodal assessment represents an integral part of staging procedure for endometrial cancer. The widespread diffusion of sentinel node mapping determinates a phenomenon of migration from stage I to stage III disease, especially for low-risk endometrial cancer patients. The adoption of sentinel node mapping and pathological ultrastaging increase the detection of low volume disease (i.e., micrometastasis and isolated tumor cells), being low volume disease detected in >30% of patients with positive nodes. The prognostic role of low volume disease is discussed as well as the possible adjuvant strategies for patients diagnosed with micrometastasis and isolated tumor cells. The role of further prospective treatments in endometrial cancer, including molecular and genetic profiling, is critically reviewed.
淋巴结评估是子宫内膜癌分期程序的一个组成部分。前哨淋巴结绘图的广泛传播导致了疾病从 I 期到 III 期的转移现象，特别是对于低危子宫内膜癌患者。前哨淋巴结绘图和病理超分期的采用增加了低容量疾病（即微转移和孤立肿瘤细胞）的检测，在阳性淋巴结患者中超过 30%检测到低容量疾病。还讨论了低容量疾病的预后作用以及诊断为微转移和孤立肿瘤细胞的患者的可能辅助策略。批判性地回顾了包括分子和遗传分析在内的子宫内膜癌进一步的前瞻性治疗的作用。
