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Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma
Sentinel lymph node (SLN) biopsy has emerged as an alternative staging approach in women with assumed early-stage endometrial carcinoma. Through image-guided surgery and pathologic ultrastaging, the SLN approach is introducing “precision medicine” to the surgical management of gynecologic cancers, p...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306601/ https://www.ncbi.nlm.nih.gov/pubmed/34300260 http://dx.doi.org/10.3390/jcm10143094 |
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author | Eriksson, Ane Gerda Z Davidson, Ben Bjerre Trent, Pernille Eyjólfsdóttir, Brynhildur Dahl, Gunn Fallås Wang, Yun Staff, Anne Cathrine |
author_facet | Eriksson, Ane Gerda Z Davidson, Ben Bjerre Trent, Pernille Eyjólfsdóttir, Brynhildur Dahl, Gunn Fallås Wang, Yun Staff, Anne Cathrine |
author_sort | Eriksson, Ane Gerda Z |
collection | PubMed |
description | Sentinel lymph node (SLN) biopsy has emerged as an alternative staging approach in women with assumed early-stage endometrial carcinoma. Through image-guided surgery and pathologic ultrastaging, the SLN approach is introducing “precision medicine” to the surgical management of gynecologic cancers, providing a comprehensive evaluation of high-yield lymph nodes. This approach improves the surgeons’ ability to detect small-volume metastatic disease while reducing intraoperative and postoperative morbidity associated with lymphadenectomy. Although the majority of clinicians in Europe and the USA have recognized the value of SLN biopsy in endometrial carcinoma and introduced this as part of clinical practice, there is ongoing debate regarding its role in very low-risk patients as well as in patients at high risk of nodal metastasis. The significance of low-volume metastasis is not fully understood, and there is no consensus in regard to how the presence of isolated tumor cells should guide adjuvant therapy. Standardized protocols for histopathologic evaluation of SLNs are lacking. In this review article we aim to provide a framework for the introduction of SLN biopsy in endometrial cancer, give an updated overview of the existing literature, as well as discuss potential controversies and unanswered questions regarding this approach and future directions. |
format | Online Article Text |
id | pubmed-8306601 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83066012021-07-25 Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma Eriksson, Ane Gerda Z Davidson, Ben Bjerre Trent, Pernille Eyjólfsdóttir, Brynhildur Dahl, Gunn Fallås Wang, Yun Staff, Anne Cathrine J Clin Med Review Sentinel lymph node (SLN) biopsy has emerged as an alternative staging approach in women with assumed early-stage endometrial carcinoma. Through image-guided surgery and pathologic ultrastaging, the SLN approach is introducing “precision medicine” to the surgical management of gynecologic cancers, providing a comprehensive evaluation of high-yield lymph nodes. This approach improves the surgeons’ ability to detect small-volume metastatic disease while reducing intraoperative and postoperative morbidity associated with lymphadenectomy. Although the majority of clinicians in Europe and the USA have recognized the value of SLN biopsy in endometrial carcinoma and introduced this as part of clinical practice, there is ongoing debate regarding its role in very low-risk patients as well as in patients at high risk of nodal metastasis. The significance of low-volume metastasis is not fully understood, and there is no consensus in regard to how the presence of isolated tumor cells should guide adjuvant therapy. Standardized protocols for histopathologic evaluation of SLNs are lacking. In this review article we aim to provide a framework for the introduction of SLN biopsy in endometrial cancer, give an updated overview of the existing literature, as well as discuss potential controversies and unanswered questions regarding this approach and future directions. MDPI 2021-07-13 /pmc/articles/PMC8306601/ /pubmed/34300260 http://dx.doi.org/10.3390/jcm10143094 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Eriksson, Ane Gerda Z Davidson, Ben Bjerre Trent, Pernille Eyjólfsdóttir, Brynhildur Dahl, Gunn Fallås Wang, Yun Staff, Anne Cathrine Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma |
title | Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma |
title_full | Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma |
title_fullStr | Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma |
title_full_unstemmed | Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma |
title_short | Update on Sentinel Lymph Node Biopsy in Surgical Staging of Endometrial Carcinoma |
title_sort | update on sentinel lymph node biopsy in surgical staging of endometrial carcinoma |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306601/ https://www.ncbi.nlm.nih.gov/pubmed/34300260 http://dx.doi.org/10.3390/jcm10143094 |
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