1.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
2.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
3.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
4.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
5.Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India
Kanika Batra MODI ; Arnika Kumari KASHYAP ; Manvika CHANDEL ; Komal AGRAWAL ; Harit Kumar CHATURVEDI
Obstetrics & Gynecology Science 2025;68(2):148-154
Objective:
To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.
Methods:
Between March 2017 and December 2023, 210 patients were included in the study. A total of 412 SLNs were detected in 210 patients using intracervical ICG dye injections.
Results:
The pathologically confirmed detection rate was >95%. A total of 25 patients (11.9%) exhibited positive sentinel metastasis detected through pathological and immunohistochemical analysis, with in five (2.4%), micro-metastasis in six (2.9%), and macro-metastasis in 14 patients (6.7%). SLN metastasis with micro- and macro-metastases changed to stage III; therefore, adjuvant therapy was administered in the form of chemotherapy and radiation therapy. Of the 210 patients, 186 (88.5%) remained at low and intermediate risk after the final histopathological analysis. The other 24 patients exhibited SLN metastasis, high-grade EC, higher-stage detection, or high risk on molecular profiling.
Conclusion
A change in stage was observed in 11.9% of patients, and adjuvant therapy was administered to 20 patients, of whom 16 received adjuvant therapy based solely on SLN involvement (in the form of micro- and macro-metastasis), thus preventing undertreatment. Overtreatment was reduced in six patients who were classified as high-grade and non-endometrioid types with SLN metastases.
6. Assessment of colistin resistance in Gram negative bacteria from clinical samples in resource-limited settings
Shubham CHAUHAN ; Narinder KAUR ; Jyoti CHAUHAN ; Harit KUMAR ; Adesh K. SAINI
Asian Pacific Journal of Tropical Medicine 2022;15(8):367-373
Objective: To find a proper method to assess colistin resistance in multidrug resistant Gram negative bacteria (MDR-GNB) on a routine basis in resource limited settings. Methods: Clinical samples were processed. MDR-GNB were identified and were examined for colistin resistance by colistin broth elution method, colistin agar method, and colistin disk elution screening method. Broth microdilution method was used the gold standard. Results: A total of 10 235 clinical samples were processed, in which 857 (8.4%) MDR-GNB were identified. The very significant errors, categorical agreement, major errors, positive predictive values, negative predictive values, specificity and sensitivity of all the phenotypic methods were 5.5%, 0%, 94.4%, 100%, 99.6%, 100% and 94.4%, respectively for the detection of colistin resistance. The colistin elution screening method was cheap and easy to perform with similar results to broth microdilution method. Conclusions: All the evaluation methods for colistin resistance showed similar results. So the laboratories can choose any method for detection of colistin resistance. However, we recommend colistin disk elution screening method because, it is easy and cheap and can be performed in limited resources.