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Prospective evaluation of sentinel node navigation surgery in Japanese patients with low-risk endometrial cancer-safety and occurrence of lymphedema.

日本低危子宫内膜癌患者前哨淋巴结导航手术的前瞻性评价-安全性和淋巴水肿的发生。

  • 影响因子:0
  • DOI:10.1093/jjco/hyaa252
  • 作者列表:"Niikura H","Toki A","Nagai T","Okamoto S","Shigeta S","Tokunaga H","Shimada M","Watanabe M","Yaegashi N
  • 发表时间:2021-04-01
Abstract

OBJECTIVE:The present study aimed to clarify the occurrence rate of lymphedema and prognosis in patients with endometrial cancer according to sentinel lymph node biopsy alone with intraoperative histopathological examination. METHODS:The study included 45 consecutive patients with endometrial cancer treated at Tohoku University Hospital between October 2014 and August 2017. All patients had endometrial carcinoma with endometrioid histology Grade 1 or Grade 2 confirmed by biopsy and stage I on magnetic resonance imaging and/or computed tomography at their preoperative evaluation. Sentinel lymph node detection was performed by radioisotope and dye. Patients who were diagnosed intraoperatively as negative for sentinel lymph node metastasis did not undergo further systematic pelvic lymphadenectomy. The occurrence rate of lymphedema and prognosis was evaluated. RESULTS:Bilateral sentinel lymph nodes were detected in 44 of 45 patients (97%). Forty-three patients underwent sentinel lymph node biopsy alone, and only two patients underwent systematic lymphadenectomy. Sentinel lymph node metastases were detected in one patient intraoperatively and two patients postoperatively as ITCs. No patients experienced recurrence. New symptomatic lower-extremity lymphedema was identified in one of 43 patients (2.3%) who underwent sentinel lymph node biopsy alone. CONCLUSION:Sentinel lymph node biopsy alone with intraoperative histopathological diagnosis appears to be a safe and effective strategy to detect lymph node metastasis and to reduce the number of patients with lower-extremity lymphedema among patients with endometrial cancer.

摘要

目的: 本研究旨在通过前哨淋巴结活检及术中组织病理学检查,明确子宫内膜癌患者淋巴水肿的发生率及预后。 方法: 本研究包括2014年10月至2017年8月期间在东北大学医院接受治疗的45例子宫内膜癌患者。所有患者都患有子宫内膜癌,其子宫内膜样组织学为1级或2级,术前评估时通过活检和磁共振成像和/或计算机断层扫描证实为I期。通过放射性同位素和染料进行前哨淋巴结检测。术中诊断为前哨淋巴结转移阴性的患者未进行进一步的系统性盆腔淋巴结清扫术。评估淋巴水肿发生率及预后。 结果: 45例患者中44例 (97%) 检出双侧前哨淋巴结。43例患者仅行前哨淋巴结活检,仅2例患者行系统性淋巴结清扫术。1例术中发现前哨淋巴结转移,2例术后发现前哨淋巴结转移。没有患者出现复发。在43例 (2.3%) 仅接受前哨淋巴结活检的患者中,有1例发现了新的下肢淋巴水肿症状。 结论: 在子宫内膜癌患者中,前哨淋巴结活检联合术中组织病理学诊断是发现淋巴结转移和减少下肢淋巴水肿患者的安全有效的方法。

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作者列表:["Louvrier A","Terranova L","Meyer C","Meyer F","Euvrard E","Kroemer M","Rolin G"]

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