![]() SLN biopsy may be recommended for patients with thick melanomas (T4 > 4.0 mm in Breslow thickness), after a discussion of the potential benefits and risks of harm. Routine SLN biopsy is not recommended for patients with thin melanomas that are T1a (nonulcerated lesions 1.0 to 4.0 mm). Lyman, Fred Hutchinson Cancer Research Center, Seattle, WA. Moncrieff, Norfolk and Norwich University Hospital, Norwich, United Kingdom and Gary H. Delman, Emory University, Atlanta, GA Mark Gorman, Silver Spring, MD Marc D. Lee Moffitt Cancer Center and Research Institute, Tampa, FL Keith A. Berman, Broward Health, Fort Lauderdale Jonathan S. Balch, MD Anderson Cancer Center, Houston, TX Barry S. Akhurst, Peter MacCallum Cancer Centre, Victoria, Australia Charlotte Ariyan, Memorial Sloan Kettering Cancer Center, New York, NY Charles M. Kirkwood, University of Pittsburgh Cancer Institute, Pittsburgh, PA Timothy J. Agarwala, St Luke's Cancer Center, Easton John M. Kennedy, American Society of Clinical Oncology, Alexandria, VA Sanjiv S. Faries, The Angeles Clinic and Research Institute, Santa Monica Alistair Cochran, University of California, Los Angeles Center for Health Services, Los Angeles, CA Erin B. Wong, Dartmouth-Hitchcock Medical Center, Lebanon, NH Mark B. These results are comparable to the rates reported in the literature and shows that, in nonspecialized centers, this approach is safe and reproducible without affecting cancer-specific outcomes.Sandra L. No recurrences occurred in this cohort with a median follow-up of 22 months.Ĭonclusions: SLNB is a sensitive and specific method for assessing lymph-node involvement in patients with clinical stage-I endometrial cancers. No other patients had false–negative SLNs. Non-SLNs were positive in 3 patients, all with high-risk histologies. At least 1 SLN was detected in 95.4% of cases. The majority of cancers were endometrioid (73%), followed by UPSC (15.0%), MMMT (5.0%), and CC (4%). Results: A total of 92 cases were included: 69 stage IA 12 stage IB 3 stage II and 8 stage III (2 IIIA, 2 IIIC1, 4 IIIC2). The medical records were queried for clinical or radiographic evidence of recurrences. Sentinel lymph nodes (SLNs) were evaluated using ultrastaging protocols with serial sectioning and cytokeratin staining. In addition to SLNB, PPALND was performed for patients with MMMT, UPSC, or CC. ![]() Para-aortic LND was performed at the discretion of the surgeon. Per the algorithm, patients with suboptimal lymph-node mapping or nodes suspicious for metastasis underwent a side-specific pelvic lymph-node dissection (LND). Indocyanine green was injected into the cervix bilaterally. All patients had undergone either robot-assisted or laparoscopic hysterectomies with SLNB. Endometrioid, uterine papillary serous (UPSC), malignant mixed-mesodermal tumor (MMMT), and clear-cell (CC) histologies were included. Materials and Methods: Cases of patients with clinical stage-I endometrial cancer were retrospectively reviewed from September 2016 through February 2020. The aim of this research was to demonstrate that SLNB is feasible, reproducible, and sensitive without affecting cancer-specific outcomes when implemented at nonspecialized centers. These data have been largely published from high-volume specialized institutions, but complete PPALND is still performed by many surgeons at smaller nonspecialized centers. Objective: Sentinel lymph-node biopsy (SLNB) is now as alternative to pelvic and para-aortic lymph-node dissection (PPALND) for managing endometrial cancers.
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