Treatment and prognosis analysis of endometrial cancer with positive sentinel lymph node biopsy
10.3760/cma.j.cn115355-20241008-00458
- VernacularTitle:前哨淋巴结活组织检查术阳性子宫内膜癌的治疗及预后分析
- Author:
Hao WANG
1
;
Liangzi JIANG
1
;
Jinxia ZHOU
1
;
Li YAN
1
Author Information
1. 山东第一医科大学第一附属医院（山东省千佛山医院）妇产科，济南 250014
- Publication Type:Journal Article
- Keywords:
Endometrial neoplasms;
Sentinel lymph node biopsy;
Lymph node excision;
Prognosis
- From:
Cancer Research and Clinic
2025;37(5):357-361
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical significance of complementary systematic lymphadenectomy (SLND) for advanced endometrial cancer (EC) with positive sentinel lymph node biopsy (SLNB) results and the risk factors influencing the prognosis of this group of individuals.Methods:A retrospective case-controlled study was conducted. The clinical data of EC patients diagnosed by histopathologic examination between January 2000 and December 2018 in National Cancer Institute the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. SLNB-positive EC patients were screened and were classified into the SLNB group and the SLNB+SLND group according to the lymph node surgical approach. χ2 test was used for the comparison of clinicopathological characteristics between the 2 groups, the Kaplan-Meier method was used for plotting the survival curves, and the Cox proportional hazards model was used for univariate and multivariate analyses on the factors influencing patients' overall survival (OS). Results:A total of 222 patients were included, including 86 cases in the SLNB group and 136 cases in the SLNB+SLND group, and there were no statistically significant differences in the comparison of clinicopathologic characteristics between the 2 groups (all P > 0.05). The 1-, 3-year OS rates were 94.0%, 80.5%, respectively in the SLNB group; the 1-, 3-year OS rates were 91.8%, 75.7%, respectively in the SLNB+SLND group, and the difference in the OS was not statistically significant ( χ2 = 0.05, P = 0.818). Multivariate Cox regression analysis showed that age ≥ 71 years ( HR = 2.35, 95% CI: 1.27-4.35, P = 0.007), histologic grade Ⅲ ( HR = 3.80, 95% CI: 1.22-11.83, P = 0.021), and not receiving radiotherapy ( HR = 2.08, 95% CI: 1.17-3.70, P = 0.013) were independent risk factors for OS in SLNB-positive EC patients. Conclusions:Age, histologic grade and radiotherapy are independent influencing factors of OS in advanced EC patients with positive SLNB. The further SLND does not provide an additional survival benefit for patients.
