目的:探讨早期宫颈癌患者行宫颈锥切术加淋巴结评估前哨淋巴结标测的安全性。
方法:永恒项目是一个回顾性项目,多机构研究收集接受保留生育力治疗的早期宫颈癌患者的数据。这里,我们比较了与三种节点评估方法相关的结果:前哨节点映射(SNM),SNM加备用淋巴结清扫术(SNM+LND);盆腔淋巴结清扫术(LND)。
结果:评估了123例(IA1-IB1期宫颈癌)患者的图表。患者年龄中位数为34岁(范围,22-44)年。SNM,SNM+LND,和LND在32(26%)中进行,31(25.2%),60名(48.8%)患者,分别。总的来说,8例(6.5%)患者被诊断为阳性淋巴结.两个(3.3%),三人(9.7%),在患有LND的患者中发现了三名(9.4%)患者,SNM+LND,和SNM分别。考虑到63例接受SNM的患者(31SNM+LND和32SNM单独),大转移,微转移,和分离的肿瘤细胞检测到四个(3.2%),三人(2.4%),和一名(0.8%)患者,分别。所有淋巴结阳性的患者都停止了保留生育力的治疗。即使在淋巴结评估阴性后,其他两名患者(LND组一名(1.7%)和SNM组一名(3.1%))仍需要子宫切除术。在中位随访53.6(范围,1.3,158.0)个月,9例(7.3%)和2例(1.6%)患者出现宫颈和骨盆淋巴结复发,分别。无病(p=0.332,对数秩检验)和总生存期(p=0.769,对数秩检验)在各组之间相似。
结论:在此回顾性经验中,SNM支持LND的长期肿瘤学有效性,降低发病率。
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.