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Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance

Objective: To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. Methods: A single institutional retrospective study was carried out, which included all patients with endometrial cancer who underwe...

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Autores principales: García Pineda, Virginia, Hernández Gutiérrez, Alicia, Gracia Segovia, Myriam, Siegrist Ridruejo, Jaime, Diestro Tejeda, María Dolores, Zapardiel, Ignacio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356149/
https://www.ncbi.nlm.nih.gov/pubmed/32630498
http://dx.doi.org/10.3390/jcm9061999
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author García Pineda, Virginia
Hernández Gutiérrez, Alicia
Gracia Segovia, Myriam
Siegrist Ridruejo, Jaime
Diestro Tejeda, María Dolores
Zapardiel, Ignacio
author_facet García Pineda, Virginia
Hernández Gutiérrez, Alicia
Gracia Segovia, Myriam
Siegrist Ridruejo, Jaime
Diestro Tejeda, María Dolores
Zapardiel, Ignacio
author_sort García Pineda, Virginia
collection PubMed
description Objective: To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. Methods: A single institutional retrospective study was carried out, which included all patients with endometrial cancer who underwent surgical treatment between January 2007 and December 2016. We analyzed the progression-free survival (PFS) and overall survival (OS) of all patients after sentinel node biopsy and full nodal surgical staging according to their final pathological nodal status, focusing on the impact of the size of nodal metastasis. Results: A total of 270 patients were operated on during the study period; among them, 230 (85.2%) patients underwent nodal staging. On final pathology, 196 (85.2%) patients had negative lymph nodes; low-volume metastasis (LVM) was present in 14 (6.1%) patients: 6 (2.6%) patients had isolated tumor cells (ITCs) and 8 (3.5%) patients presented just micrometastasis; additionally, 20 (8.7%) patients presented macrometastasis. After a median (range) follow-up of 60 (0–146) months, patients with macrometastasis showed a significantly worse PFS compared to LVM and node-negative patients (61.1% vs. 71.4% vs. 83.2%, respectively; p = 0.018), and similar results were obtained for 5-year OS (50% vs. 78.6% vs. 81.5%, respectively; p < 0.001). Half of the patients presenting LVM did not receive adjuvant treatment. Moreover, LVM had a moderate nonsignificant decrease in 5-year PFS compared to node-negative patients. Conclusions: Patients with endometrial cancer and low-volume nodal metastasis demonstrated a better prognosis than those presenting macrometastasis. Low-volume metastasis did not show worse oncological outcomes than node-negative patients, although there was a slight decrease in progression-free survival.
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spelling pubmed-73561492020-07-31 Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance García Pineda, Virginia Hernández Gutiérrez, Alicia Gracia Segovia, Myriam Siegrist Ridruejo, Jaime Diestro Tejeda, María Dolores Zapardiel, Ignacio J Clin Med Article Objective: To evaluate the oncological outcomes of patients with low-volume metastasis compared to those with macrometastasis and negative nodes in endometrial cancer. Methods: A single institutional retrospective study was carried out, which included all patients with endometrial cancer who underwent surgical treatment between January 2007 and December 2016. We analyzed the progression-free survival (PFS) and overall survival (OS) of all patients after sentinel node biopsy and full nodal surgical staging according to their final pathological nodal status, focusing on the impact of the size of nodal metastasis. Results: A total of 270 patients were operated on during the study period; among them, 230 (85.2%) patients underwent nodal staging. On final pathology, 196 (85.2%) patients had negative lymph nodes; low-volume metastasis (LVM) was present in 14 (6.1%) patients: 6 (2.6%) patients had isolated tumor cells (ITCs) and 8 (3.5%) patients presented just micrometastasis; additionally, 20 (8.7%) patients presented macrometastasis. After a median (range) follow-up of 60 (0–146) months, patients with macrometastasis showed a significantly worse PFS compared to LVM and node-negative patients (61.1% vs. 71.4% vs. 83.2%, respectively; p = 0.018), and similar results were obtained for 5-year OS (50% vs. 78.6% vs. 81.5%, respectively; p < 0.001). Half of the patients presenting LVM did not receive adjuvant treatment. Moreover, LVM had a moderate nonsignificant decrease in 5-year PFS compared to node-negative patients. Conclusions: Patients with endometrial cancer and low-volume nodal metastasis demonstrated a better prognosis than those presenting macrometastasis. Low-volume metastasis did not show worse oncological outcomes than node-negative patients, although there was a slight decrease in progression-free survival. MDPI 2020-06-25 /pmc/articles/PMC7356149/ /pubmed/32630498 http://dx.doi.org/10.3390/jcm9061999 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
García Pineda, Virginia
Hernández Gutiérrez, Alicia
Gracia Segovia, Myriam
Siegrist Ridruejo, Jaime
Diestro Tejeda, María Dolores
Zapardiel, Ignacio
Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
title Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
title_full Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
title_fullStr Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
title_full_unstemmed Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
title_short Low-Volume Nodal Metastasis in Endometrial Cancer: Risk Factors and Prognostic Significance
title_sort low-volume nodal metastasis in endometrial cancer: risk factors and prognostic significance
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356149/
https://www.ncbi.nlm.nih.gov/pubmed/32630498
http://dx.doi.org/10.3390/jcm9061999
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