Zhang Sai, Zheng Juan, Zhu Dandan
Department of Obstetrics and Gynecology, General Hospital of Xuzhou Mining Group, Xuzhou, Jiangsu, China.
Front Oncol. 2025 May 20;15:1584447. doi: 10.3389/fonc.2025.1584447. eCollection 2025.
This study aimed to assess the prognosis of endometrial cancer (EC) patients after sentinel lymph node biopsy (SLNB) or lymph node dissection (LND) alone.
EMBASE, PUBMED, COCHRANE, and WEB of SCIENCE were thoroughly searched for relevant articles until October 2024. The outcomes of interest encompassed overall survival (OS), progression-free survival (PFS), and disease-specific survival (DSS). Data analysis was made in STATA 18.0. The Newcastle-Ottawa Scale tool was leveraged to appraise study quality.
13 studies were included, involving 36621 EC patients. No difference was revealed in OS between SLNB and LND (HR=1.04, 95%CI: 0.80-1.33; P=0.789). In subgroup analyses, the SLNB group from survival curves had worse OS (HR=1.63, 95%CI: 1.04-2.56; P=0.035); the SLNB group with intermediate- to high-risk EC had better OS (HR=0.20, 95%CI: 0.08-0.49; P<0.001). No difference was revealed in PFS between SLNB and LND (HR=0.99, 95%CI: 0.76-1.28; P=0.927). SLNB had better PFS in Asia (HR=0.44, 95% CI: 0.20-0.98, P=0.046) and stage I-III EC (HR=0.46, 95% CI: 0.24-0.89; P=0.021). No statistical difference was found in DSS (HR=3.18, 95%CI: 0.91-11.07; P=0.069).
SLNB is an effective alternative to conventional LND in either low- or intermediate-high-risk EC patients. However, due to the retrospective nature of most included studies and the limited data on high-risk patients, further prospective randomized controlled trials are warranted to validate these findings.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024489323.
本研究旨在评估单独进行前哨淋巴结活检（SLNB）或淋巴结清扫术（LND）后子宫内膜癌（EC）患者的预后。
全面检索了EMBASE、PUBMED、COCHRANE和科学网（WEB of SCIENCE），以查找相关文章，直至2024年10月。感兴趣的结局包括总生存期（OS）、无进展生存期（PFS）和疾病特异性生存期（DSS）。在STATA 18.0中进行数据分析。利用纽卡斯尔-渥太华量表工具评估研究质量。
纳入13项研究，涉及36621例EC患者。SLNB和LND之间的OS无差异（HR = 1.04，95%CI：0.80 - 1.33；P = 0.789）。在亚组分析中，生存曲线中的SLNB组OS较差（HR = 1.63，95%CI：1.04 - 2.56；P = 0.035）；中高危EC的SLNB组OS较好（HR = 0.20，95%CI：0.08 - 0.49；P < 0.001）。SLNB和LND之间的PFS无差异（HR = 0.99，95%CI：0.76 - 1.28；P = 0.927）。SLNB在亚洲（HR = 0.44，95%CI：0.20 - 0.98，P = 0.046）和I - III期EC（HR = 0.46，95%CI：0.24 - 0.89；P = 0.021）中PFS较好。DSS无统计学差异（HR = 3.18，95%CI：0.91 - 11.07；P = 0.069）。
对于低危或中高危EC患者，SLNB是传统LND的有效替代方法。然而，由于大多数纳入研究的回顾性性质以及高危患者的数据有限，有必要进行进一步的前瞻性随机对照试验来验证这些发现。
