Sentinel lymph node biopsy and morbidity outcomes in early cervical cancer: Results of a multicentre randomised trial (SENTICOL-2).
Adenocarcinoma
/ pathology
Adult
Carcinoma, Squamous Cell
/ pathology
Female
Follow-Up Studies
Humans
Hysterectomy
/ mortality
Lymph Node Excision
/ mortality
Middle Aged
Morbidity
Neoplasm Recurrence, Local
/ epidemiology
Prognosis
Prospective Studies
Sentinel Lymph Node Biopsy
/ mortality
Survival Rate
Uterine Cervical Neoplasms
/ pathology
Lymphadenectomy
Morbidity
Quality of life
Sentinel node biopsy
Uterine cervical neoplasm
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
13
12
2020
revised:
24
01
2021
accepted:
02
02
2021
pubmed:
28
3
2021
medline:
26
10
2021
entrez:
27
3
2021
Statut:
ppublish
Résumé
Pelvic lymph node dissection has been the standard of care for patients with early cervical cancer. Sentinel node (SN) mapping is safe and feasible and may increase the detection of metastatic disease, but benefits of omitting pelvic lymph node dissection in terms of decreased morbidity have not been demonstrated. In an open-label study, patients with early cervical carcinoma (FIGO 2009 stage IA2 to IIA1) were randomly assigned to SN resection alone (SN arm) or SN and pelvic lymph node dissection (SN + PLND arm). SN resection was followed by radical surgery of the tumour (radical hysterectomy or radical trachelectomy). The primary end-point was morbidity related to the lymph node dissection; 3-year recurrence-free survival was a secondary end-point. A total of 206 patients were eligible and randomly assigned to the SN arm (105 patients) or SN + PLND arm (101 patients). Most patients had stage IB1 lesion (87.4%). No false-negative case was observed in SN + PLND arm. Lymphatic morbidity was significantly lower in the SN arm (31.4%) than in the SN + PLND arm (51.5%; p = 0.0046), as was the rate of postoperative neurological symptoms (7.8% vs. 20.6%, p = 0.01, respectively). However, there was no significant difference in the proportion of patients with significant lymphoedema between the two groups. During the 6-month postoperative period, the difference in morbidity decreased over time. The 3-year recurrence-free survival was not significantly different (92.0% in SN arm and 94.4% in SN + PLND arm). SN resection alone is associated with early decreased lymphatic morbidity when compared with SN + PLND in early cervical cancer.
Identifiants
pubmed: 33773275
pii: S0959-8049(21)00091-5
doi: 10.1016/j.ejca.2021.02.009
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
307-315Investigateurs
P Morice
(P)
P Mathevet
(P)
E Stoeckle
(E)
D Querleu
(D)
V Fourchotte
(V)
F Lécuru
(F)
A S Bats
(AS)
M Baron
(M)
O Graesslin
(O)
J Lévèque
(J)
B Ott
(B)
E Daraï
(E)
D Lanvin
(D)
C Pomel
(C)
H Marret
(H)
G Mage
(G)
G Houvenaeghel
(G)
J J Baldauf
(JJ)
V Conri
(V)
S Douvier
(S)
Y Delpech
(Y)
E Leblanc
(E)
Y Fouché
(Y)
L Boulanger
(L)
P Descamps
(P)
J M Classe
(JM)
D Raudrant
(D)
P Rouanet
(P)
Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.