Sehnal Borek, Waldauf Petr, Matej Radoslav, Hruda Martin, Robova Helena, Drozenova Jana, Pichlik Tomas, Zapletal Jan, Rob Lukas, Halaska Michael J
Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Srobarova 1150/50, Prague 10, 100 34, Czech Republic.
Department of Obstetrics and Gynecology, Third Faculty of Medicine, Faculty Hospital Kralovske Vinohrady, Charles University, Srobarova 1150/50, Prague 10, 100 34, Czech Republic.
BMC Cancer. 2025 Apr 8;25(1):638. doi: 10.1186/s12885-025-14037-8.
This study aimed to evaluate the effectiveness of different tracers´ application techniques for sentinel lymph node (SLN) detection in women with endometrial cancer undergoing laparotomy. Additionally, potential risk factors for SLN detection failure were assessed.
We retrospectively analyzed data from 248 endometrial cancer patients who underwent abdominal surgery with SLN mapping between January 2020 and March 2024. Statistical analyses were conducted using the Wilcoxon rank sum test for continuous variables and either Pearson's chi-square test or Fisher's exact test for categorical variables, with a significance level set at p < 0.05.
Group I + S consisted of 147 women with intracervical and subserosal tracers´application and group I + I included 101 women with intracervical and intrafundal application. Successful detection of SLN on both sides was achieved in 39.9% (99/248) of all patients, in 38.1% (56/147) in the I + S group and in 42.6% (43/101) in the I + I group, respectively. SLNs were identified in 32.7% (81/248) of all patients on only one side of the pelvis, in 31.3% (46/147) in the I + S and in 34.7% (35/101) in the I + I group, respectively. No SLNs were detected in 27.4% (68/248) of all subjects, comprising 30.6% (45/147) from the I + S and 22.8% (23/101) from the I + I group. Although the success rate of SLN detection was higher in the I + I group and on the right side of the pelvis regardless of the detection method, these differences were not statistically significant. An age exceeding 66.3 years was recognized as a critical risk factor for successful detection, other followed factors did not demonstrate a statistically significant impact on overall detection success. Additional significant risk factors were identified: depth of tumor myometrial invasion on the right side, history of pelvic surgery, and total tumor volume on the left side.
The study did not reveal significant differences in SLN mapping success between the groups receiving intracervical + intrafundal and intracervical + subserosal tracers´applications among endometrial cancer patients treated via open surgery. Overall, older age emerged as the most critical risk factor for SLN detection failure, while other assessed factors did not show a statistically significant impact on overall detection success.
Institution University Hospital Královské Vinohrady, Prague, Czech Republic.
EK-VP-21-0-2023. Date of registration 7-JUN-2023. This study was retrospectively registered in compliance with the Declaration of Helsinki.
本研究旨在评估不同示踪剂应用技术在接受剖腹手术的子宫内膜癌女性中检测前哨淋巴结（SLN）的有效性。此外，还评估了SLN检测失败的潜在风险因素。
我们回顾性分析了2020年1月至2024年3月期间248例行腹部手术并进行SLN定位的子宫内膜癌患者的数据。连续变量采用Wilcoxon秩和检验进行统计分析，分类变量采用Pearson卡方检验或Fisher精确检验，显著性水平设定为p < 0.05。
I + S组由147例宫颈内和浆膜下应用示踪剂的女性组成，I + I组包括101例宫颈内和子宫底内应用示踪剂的女性。所有患者中，双侧SLN成功检测率为39.9%（99/248），I + S组为38.1%（56/147），I + I组为42.6%（43/101）。所有患者中，仅在骨盆一侧检测到SLN的比例为32.7%（81/248），I + S组为31.3%（46/147），I + I组为34.7%（35/101）。所有受试者中，27.4%（68/248）未检测到SLN，其中I + S组占30.6%（45/147），I + I组占22.8%（23/101）。尽管I + I组以及无论采用何种检测方法时骨盆右侧的SLN检测成功率较高，但这些差异无统计学意义。年龄超过66.3岁被认为是成功检测的关键风险因素，其他因素对总体检测成功率未显示出统计学显著影响。还确定了其他显著风险因素：右侧肿瘤肌层浸润深度、盆腔手术史和左侧肿瘤总体积。
本研究未发现接受宫颈内 + 子宫底内和宫颈内 + 浆膜下示踪剂应用的子宫内膜癌患者在开放手术中SLN定位成功率存在显著差异。总体而言，年龄较大是SLN检测失败的最关键风险因素，而其他评估因素对总体检测成功率未显示出统计学显著影响。
机构为捷克共和国布拉格的克拉洛夫斯基·维诺赫拉迪大学医院。
EK-VP-21-0-2023。注册日期：2023年6月7日。本研究按照《赫尔辛基宣言》进行回顾性注册。
