Objective: To investigate the safety of sentinel node mapping for patients with early-stage cervical cancer undergoing cervical conization plus nodal evaluation. Methods: The ETERNITY project is a retrospective, multi-institutional study collecting data of patients with early-stage cervical cancer undergoing fertility-sparing treatment. Here, we compared outcomes related to three methods of nodal assessment: sentinel node mapping (SNM), SNM plus backup lymphadenectomy (SNM + LND); pelvic lymphadenectomy (LND). Results: Charts of 123 patients (with stage IA1-IB1 cervical cancer) were evaluated. Median patients' age was 34 (range, 22-44) years. SNM, SNM + LND, and LND were performed in 32 (26 %), 31 (25.2 %), and 60 (48.8 %) patients, respectively. Overall, eight (6.5 %) patients were diagnosed with positive nodes. Two (3.3 %), three (9.7 %), and three (9.4 %) patients were detected in patients who had LND, SNM + LND, and SNM respectively. Considering the 63 patients undergoing SNM (31 SNM + LND and 32 SNM alone), macrometastases, micrometastases, and isolated tumor cells were detected in four (3.2 %), three (2.4 %), and one (0.8 %) patients, respectively. All patients with positive nodes discontinued the fertility sparing treatment. Other two patients (one (1.7 %) in the LND group and one (3.1 %) in the SNM group) required hysterectomy even after negative nodal evaluation. After a median follow-up of 53.6 (range, 1.3, 158.0) months, nine (7.3 %) and two (1.6 %) patients developed cervical and pelvic nodes recurrences, respectively. Disease-free (p = 0.332, log-rank test) and overall survival (p = 0.769, log-rank test) were similar among groups. Conclusions: In this retrospective experience, SNM upholds long-term oncologic effectiveness of LND, reducing morbidity.
Sentinel node mapping, sentinel node mapping plus back-up lymphadenectomy, and lymphadenectomy in Early-sTage cERvical caNcer scheduled for fertilItY-sparing approach: The ETERNITY project / Bogani, Giorgio; Scambia, Giovanni; Fagotti, Anna; Fanfani, Francesco; Ciavattini, Andrea; Sopracordevole, Francesco; Malzoni, Mario; Casarin, Jvan; Ghezzi, Fabio; Vizza, Enrico; Cosentino, Francesco; Berretta, Roberto; Cuccu, Ilaria; Ferrari, Filippo Alberto; Chiappa, Valentina; Vizzielli, Giuseppe; Raspagliesi, Francesco; Bogani, Giorgio; Scambia, Giovanni; Fagotti, Anna; Fanfani, Francesco; De Vincenzo, Rosa; Ciavattini, Andrea; Sopracordevole, Francesco; Clemente, Nicolò; Del Fabro, Anna; Buttignol, Monica; Cianci, Stefano; Sarpietro, Giuseppe; Matarazzo, Maria Grazia; Malzoni, Mario; Falcone, Francesca; Casarin, Jvan; Ghezzi, Fabio; Vizza, Enrico; Berretta, Roberto; Petrillo, Marco; Capobianco, Giampiero; Scarfone, Giovanna; Casaccia, Filippo; Fichera, Mariasole; Leo, Livio; Sozzi, Giulio; Colalillo, Alessio; Cosentino, Francesco; Gardella, Barbara; Serrachioli, Renato; Raimondo, Diego; Chiantera, Vito; Ercoli, Alfredo; Dominoni, Mattia; Zupi, Enrico; Centini, Gabriele; Uccella, Stefano; Franchi, Massimo; Ferrari, Filippo Alberto; Perrone, Anna Myriam; De Iaco, Pierandrea; Multinu, Francesco; Zanagnolo, Vanna; Schivardi, Gabriella; De Vitis, Luigi Antonio; Cuccu, Ilaria; Ferrari, Federico; Vizzielli, Giuseppe; Restaino, Stefano; Driul, Lorenza; Arcieri, Martina; Sorbi, Flavia; Fambrini, Massimiliano; Aguzzoli, Lorenzo; Mandato, Vincenzo Dario; Murina, Filippo; Solima, Eugenio; Vignali, Michele; Vercellini, Paolo; Ceccaroni, Marcello; Di Donato, Violante; Giannini, Andrea; Muzii, Ludovico; Chiappa, Valentina; Palladino, Simona; Tozzi, Roberto; Cormio, Gennaro; Raspagliesi, Francesco. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - 50:9(2024). [10.1016/j.ejso.2024.108467]
Sentinel node mapping, sentinel node mapping plus back-up lymphadenectomy, and lymphadenectomy in Early-sTage cERvical caNcer scheduled for fertilItY-sparing approach: The ETERNITY project
Bogani, Giorgio
;Cuccu, Ilaria;Bogani, Giorgio;Cianci, Stefano;Cuccu, Ilaria;Vignali, Michele;Di Donato, Violante;Giannini, Andrea;Muzii, Ludovico;Tozzi, Roberto;
2024
Abstract
Objective: To investigate the safety of sentinel node mapping for patients with early-stage cervical cancer undergoing cervical conization plus nodal evaluation. Methods: The ETERNITY project is a retrospective, multi-institutional study collecting data of patients with early-stage cervical cancer undergoing fertility-sparing treatment. Here, we compared outcomes related to three methods of nodal assessment: sentinel node mapping (SNM), SNM plus backup lymphadenectomy (SNM + LND); pelvic lymphadenectomy (LND). Results: Charts of 123 patients (with stage IA1-IB1 cervical cancer) were evaluated. Median patients' age was 34 (range, 22-44) years. SNM, SNM + LND, and LND were performed in 32 (26 %), 31 (25.2 %), and 60 (48.8 %) patients, respectively. Overall, eight (6.5 %) patients were diagnosed with positive nodes. Two (3.3 %), three (9.7 %), and three (9.4 %) patients were detected in patients who had LND, SNM + LND, and SNM respectively. Considering the 63 patients undergoing SNM (31 SNM + LND and 32 SNM alone), macrometastases, micrometastases, and isolated tumor cells were detected in four (3.2 %), three (2.4 %), and one (0.8 %) patients, respectively. All patients with positive nodes discontinued the fertility sparing treatment. Other two patients (one (1.7 %) in the LND group and one (3.1 %) in the SNM group) required hysterectomy even after negative nodal evaluation. After a median follow-up of 53.6 (range, 1.3, 158.0) months, nine (7.3 %) and two (1.6 %) patients developed cervical and pelvic nodes recurrences, respectively. Disease-free (p = 0.332, log-rank test) and overall survival (p = 0.769, log-rank test) were similar among groups. Conclusions: In this retrospective experience, SNM upholds long-term oncologic effectiveness of LND, reducing morbidity.| File | Dimensione | Formato | |
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