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Shi XL, Chen S, Guo GD, Yang YL, Tong KM, Cao W, Huang LL, Zhang YR. Precise lymph node biopsy for endometrial cancer confined to the uterus: Analysis of 43 clinical cases. Taiwan J Obstet Gynecol 2024; 63:369-374. [PMID: 38802200 DOI: 10.1016/j.tjog.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To explore a precise association between tumor location and lymph node (LN) biopsy algorithm in uterine confined endometrial cancer (EC). MATERIALS AND METHODS Patients with EC treated in the Department of Obstetrics and Gynecology, South Branch of Fujian Provincial Hospital were included in this observational retrospective study. Based on the procedure of treatment, patients were separated to stage I (2015.07-2019.09) and stage II (2019.09-2021.9). In each stage, patients were separated to high and low-risk group by the predicted results. Patients in the high-risk group received systematic lymphadenectomy in stage I and sentinel lymph node (SLN) dissection in stage II. The efficiency of lymph node metastasis (LNM) detection rates was compared between stage I and stage II cases. Precise lymph node biopsy algorithm was also constructed based on the outcomes of stage II. RESULTS Overall, 43 patients, 28 in stage I and 15 in stage II, were included in the study. No recurrence or death cases had been found within follow-up terms. Based on the difference in the detection efficiency of LNM (p > 0.05), there was no difference between two stages. Thus, systematic lymphadenectomy and SLN biopsy provided similar success rates. The location of tumor site was also important for deciding whether pelvic or para-aortic SLN should be sampled for LNM. CONCLUSIONS Precise SLN biopsy for EC confined to the uterus showed comparable LNM detection rate as systematic lymphadenectomy. EC location may be used to determine whether pelvic or para-aortic SLN sampling should be conducted for treatment.
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Affiliation(s)
- Xiao-Long Shi
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China.
| | - Shuo Chen
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
| | - Guo-Dong Guo
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
| | - Yun-Ling Yang
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
| | - Kang-Mei Tong
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
| | - Wen Cao
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
| | - Lin-Lin Huang
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
| | - Yan-Ru Zhang
- Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, PR China; Department of Obstetrics and Gynecology, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, PR China
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Meta-Analysis of the Diagnostic Value of Tracer Staining Technology Based on Nanocarbon Suspension in Sentinel Lymph Node Biopsy of Breast Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2299852. [PMID: 35602338 PMCID: PMC9119750 DOI: 10.1155/2022/2299852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/11/2022] [Accepted: 04/23/2022] [Indexed: 11/18/2022]
Abstract
Objective. To evaluate the diagnostic value of the nanometer carbon suspension tracer staining technique in sentinel lymph node biopsy of breast cancer is the objective of this study. Methods. The PubMed, Embase, Cochrane Library (Central), and Web of Science (SCI Expanded), and Chinese databases (CNKI, VIP, Wan Fang, and CBM) were systematically searched for studies on the diagnostic value of nanocarbon suspension in sentinel lymph node biopsy of breast cancer. Two reviewers independently assessed the methodological quality of each study using the QUADAS-2 tool. The extracted valid data were calculated using Meta-Disc1.4 software and tested for heterogeneity. STATA14.0 software was selected for sensitivity analysis of the included studies, and publication bias was assessed using Deeks’ forest plot asymmetry test. Results. A total of 10 studies were obtained. The pooled data were as follows: sensitivity, 0.92 (0.88~0.95); specificity, 0.99 (0.98~1.00); positive likelihood ratio, 69.24 (30.34~158.02); negative likelihood ratio, 0.09 (0.06~0.13); and the combined diagnostic odds ratio, 747.40 (285.77~1954.76),
. Nanocarbon suspension tracers have an accuracy rate of 98.81% in the diagnosis of sentinel lymph nodes in breast cancer. Conclusion. Tracer staining technology based on nanocarbon suspension can accurately assess the status of lymph nodes in sentinel lymph node biopsy of breast cancer and has good stability and operability, which is worthy of clinical promotion.
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Chavda J, Mishra A, Silodia A, Yadav SK, Sharma DB, Sharma D, Khandare M. Validation sentinel lymph node biopsy study in cN0 axilla using low-cost dual dye technique: potential solution for resource poor settings. Breast Cancer Res Treat 2022; 193:105-110. [PMID: 35246773 DOI: 10.1007/s10549-022-06556-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Sentinel lymph node biopsy (SLNB) using radio-pharmaceutical and a blue dye is gold standard for axillary staging in clinically node-negative breast cancer. High costs and limited availability of radio-pharmaceutical and/or gamma probe are major deterrents in performing SLNB in developing countries. In this study, we evaluated feasibility of SLN identification (SLN-IR) of fluorescein-guided (FG) SLNB in combination with methylene blue dye (MBD). METHODS This was a prospective cross-sectional non-randomized validation study in patients with clinically node-negative axilla. Patients underwent validation SLNB using fluorescein (and blue LED light) and MBD. Axillary dissection was performed irrespective of SLNB histology. SLIN-IR and False Negative Rate (FNR) were assessed for both groups. RESULTS The SLNs were identified in 29 (96.6%) pre-chemotherapy patients and 23 (82%) post Neoadjuvant Chemotherapy (NACT) patients. The median number of sentinel lymph nodes identified was 3 (range of 1-5) in pre-chemotherapy patients and 1 (range of 1-3) in post NACT patients. The SLN-IR using MBD was 90%, FD was 86.7% and combined MBD FD was 96.7% in pre-chemotherapy patients. The SLN-IR using MBD was 82%, FD was 71% and combined MBD FD was 82% in in post NACT patients. The false negative rate (FNR) in pre-chemotherapy group was 8.0% (MBD), 8.3% (FD) and 7.4% (MBD + FD). The FNR in post NACT group was 8.7% (MBD), 10% (FD) and 8.7% (MBD + FD). CONCLUSION This prospective validation study showed adequate SLN-IR and FNR using low-cost dual dyes in early breast cancer patients and can be used in low resource settings. However, SLNB in post NACT axilla though viable along with a satisfactory FNR, is associated with low identification rate and needs further evaluation.
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Affiliation(s)
- Jayesh Chavda
- Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India
| | - Arpan Mishra
- Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India
| | - Ashutosh Silodia
- Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India
| | - Sanjay Kumar Yadav
- Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
| | - Deepti Bala Sharma
- Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India
| | - Dhananjaya Sharma
- Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India
| | - Muktesh Khandare
- Department of Pathology, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India
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