Huang Liqiong, Cheng Wei, He Chenghui, Li Xin, Huang Lu, Zhang Jiajia, Song Liwen, Zhou Yifan, Wang Chenchen, Gan Xiaoqin, Qiu Jin
Department of Obstetrics and Gynecology, Shanghai Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Obstetrics and Gynecology, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Front Med (Lausanne). 2024 Jul 24;11:1434311. doi: 10.3389/fmed.2024.1434311. eCollection 2024.
In this study, we collected perioperative and postoperative follow-up data from patients with endometrial cancer (EC) at different stages to evaluate the role of sentinel lymph node biopsy (SLNB) in endometrial cancer surgery.
A total of 186 endometrial cancer patients undergoing radical hysterectomy from January 2018 to April 2022 were retrospectively analyzed. Patients were classified into four groups. Group A comprised patients diagnosed with stage IA grade 1 and 2 endometrioid EC who underwent SLNB. Group B comprised patients with stage IA grade 1 and 2 endometrioid EC who did not undergo SLNB. Group C comprised patients with higher-grade endometrioid EC, wherein systematic lymph node dissection was performed based on SLNB results. Group D comprised patients with higher-grade endometrioid EC who did not undergo SLNB and instead underwent direct systematic lymph node dissection. Clinical, pathological data, and follow-up information for all patients were collected.
In Group A and B, SLNB was performed on 36 out of 67 patients with IA stage 1 and 2 endometrial cancer, yielding a SLN positivity rate of 5.6%. There were no significant differences observed between the two groups regarding perioperative outcomes and postoperative follow-up. Conversely, among 119 patients with higher-grade endometrial cancer, 52 underwent SLNB, with 20 patients exhibiting SLN positivity, resulting in a SLN positivity rate of 38.4%. However, the decision to undergo SLNB did not yield significant differences in perioperative outcomes and postoperative follow-up among these patients.
For stage IA grade 1 and 2 endometrioid EC, the incidence of lymph node positivity is low, omitting SLNB in this subpopulation is a feasible option. In other stages of endometrioid EC, there is no significant difference in perioperative and postoperative follow-up data between patients undergoing routine systematic lymphadenectomy and those undergoing systematic lymphadenectomy based on SLNB results. Therefore, if SLNB is not available, the standard procedure of PLND remains an option to obtain information about lymph node status, despite the surgical complications associated with this procedure.
在本研究中，我们收集了不同分期子宫内膜癌（EC）患者的围手术期及术后随访数据，以评估前哨淋巴结活检（SLNB）在子宫内膜癌手术中的作用。
回顾性分析2018年1月至2022年4月期间共186例行根治性子宫切除术的子宫内膜癌患者。患者分为四组。A组包括诊断为IA期1级和2级子宫内膜样EC且接受SLNB的患者。B组包括IA期1级和2级子宫内膜样EC但未接受SLNB的患者。C组包括高级别子宫内膜样EC患者，其中根据SLNB结果进行系统性淋巴结清扫。D组包括高级别子宫内膜样EC但未接受SLNB而是直接进行系统性淋巴结清扫的患者。收集所有患者的临床、病理数据及随访信息。
在A组和B组中，67例IA期1级和2级子宫内膜癌患者中有36例接受了SLNB，前哨淋巴结阳性率为5.6%。两组在围手术期结局和术后随访方面未观察到显著差异。相反，在119例高级别子宫内膜癌患者中，52例接受了SLNB，20例前哨淋巴结阳性，前哨淋巴结阳性率为38.4%。然而，对于这些患者，是否进行SLNB在围手术期结局和术后随访方面未产生显著差异。
对于IA期1级和2级子宫内膜样EC，淋巴结阳性发生率较低，在该亚组中省略SLNB是一种可行的选择。在子宫内膜样EC的其他分期中，接受常规系统性淋巴结清扫的患者与基于SLNB结果进行系统性淋巴结清扫的患者在围手术期和术后随访数据方面无显著差异。因此，如果无法进行SLNB，尽管该手术存在相关手术并发症，但盆腔淋巴结清扫的标准程序仍是获取淋巴结状态信息的一种选择。
