Khoptiana Olha, Svintsitskyi Valentyn, Nespryadko Sergiy, Tsip Natalia P, Gogisvanidze Teimuraz, Dzimistarishvili Mikheil, Krasylenko Dmytro, Chetverikov Mykhailo Serhiiovych, Nigutsa Igor Pavlovych, Sumtsov Dmytro, Dolyk Pavlo
Scientific and Clinical Department of the Female Reproductive System Neoplasms, National Cancer Institute, Kyiv, Ukraine.
Oncogynecological Department, Kyiv Regional Oncology Center, Kyiv, Ukraine.
Int J Womens Health. 2025 Jun 26;17:1877-1885. doi: 10.2147/IJWH.S521303. eCollection 2025.
To analyze the oncological safety of sentinel lymph node biopsy compared to lymphadenectomy. Additionally, we evaluated the postoperative complications of the two methods.
This retrospective multicenter trial included 118 patients with intermediate and high-intermediate Stage I-II endometrioid endometrial cancer. Patients with non-endometrioid tumors and those with lymphadenopathy detected on computed tomography were excluded. The study group underwent sentinel lymph node biopsy. In contrast, the control group underwent systematic lymphadenectomy up to the renal vessels, the level of the inferior mesenteric artery, or the bifurcation of the iliac vessels. Recurrence-free survival was calculated using the Kaplan-Meier method. Differences were considered statistically significant at p < 0.05 (95% confidence interval).
Patients were recruited from 2017 to March 2024. In the control group, six (5.9%) patients experienced disease recurrence and five (4.2%) died. Overall, two (1.7%) patients from both groups died from causes unrelated to recurrence. Recurrence-free survival did not significantly differ between those who underwent sentinel lymph node biopsy (96.3%, SE ± 0.036) and those who underwent lymphadenectomy (89.4%, SE ± 0.045) over 3 years from the date of surgery to the time of the first recurrence (p = 0.608). Eighteen postoperative complications were identified: 11 (9.3%) patients experienced complications within 30 days of follow-up, and 7 (5.9%) within 90 days.
Sentinel lymph node biopsy may serve as an alternative to systemic lymphadenectomy for surgical staging without compromising recurrence-free survival.
分析前哨淋巴结活检与淋巴结清扫术相比的肿瘤学安全性。此外，我们评估了这两种方法的术后并发症。
这项回顾性多中心试验纳入了118例I-II期子宫内膜样子宫内膜癌中晚期患者。排除非子宫内膜样肿瘤患者以及计算机断层扫描发现有淋巴结病的患者。研究组接受前哨淋巴结活检。相比之下，对照组接受直至肾血管、肠系膜下动脉水平或髂血管分叉处的系统性淋巴结清扫术。采用Kaplan-Meier法计算无复发生存率。p < 0.05（95%置信区间）时差异被认为具有统计学意义。
患者于2017年至2024年3月入组。对照组中有6例（5.9%）患者出现疾病复发，5例（4.2%）死亡。总体而言，两组中有2例（1.7%）患者死于与复发无关的原因。从手术日期至首次复发时间超过3年的患者中，接受前哨淋巴结活检的患者（96.3%，标准误±0.036）与接受淋巴结清扫术的患者（89.4%，标准误±0.045）的无复发生存率无显著差异（p = 0.608）。共识别出18例术后并发症：11例（9.3%）患者在随访30天内出现并发症，7例（5.9%）在90天内出现并发症。
前哨淋巴结活检可作为系统性淋巴结清扫术的替代方法用于手术分期，且不影响无复发生存率。
