Long-term follow up after sentinel node biopsy alone for early-stage cervical cancer
Long-term follow up after sentinel node biopsy alone for early-stage cervical cancer
复制标题
早期宫颈癌单纯前哨淋巴结活检后的长期随访
DOI：
10.1016/j.ygyno.2022.01.031
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发表时间：
2022
影响因子：
4.7
通讯作者：
Oda Yos
中科院分区：
文献类型：
--
作者：
Yahata Hideaki;Kodama Keisuke;Okugawa Kaoru;Hachisuga Kazuhisa;Yasutake Nobuko;Maenohara Shoji;Yagi Hiroshi;Yasunaga Masafumi;Ohgami Tatsuhiro;Onoyama Ichiro;Asanoma Kazuo;Kobayashi Hiroaki;Sonoda Kenzo;Baba Shingo;Ishigami Kousei;Ohishi Yoshihiro;Oda Yos
单独前哨淋巴结活检（SNB）可减少盆腔淋巴结切除术后并发症，如水肿和淋巴管炎;然而，SNB后的长期预后尚不清楚。本研究的目的是评估接受SNB子宫切除术或tracelectomy.MethodsWe进行SNB宫颈癌使用放射性同位素方法在2009年和2017年之间的181例患者的长期结果和并发症的早期宫颈癌患者。如果术中前哨淋巴结的评估是阴性的转移，没有进一步的淋巴结被removed.ResultsThe患者的中位年龄为34岁（范围，21-73岁）。国际妇产科联合会2008年的分期为6例患者为IA 1，18例为IA 2，154例为IB 1，3例为IIA 1。在181例患者中（44例子宫切除术，137例子宫颈切除术），8例因术中诊断为假阴性而未接受盆腔淋巴结切除术，20例在术后接受辅助治疗，4例（2.2%）在中位随访期83.5个月（范围，25-145个月）内复发。在4例复发病例中，盆腔、肺和骨各有1例复发，而其余1例患者发生盆腔和主动脉旁淋巴结转移。在这4例患者中，1例死亡，其余3例在多学科治疗后无疾病存活。5年无进展生存率和总生存率分别为98.8%和99.4%。结论SNB治疗早期宫颈癌安全、有效，不增加复发率和术后并发症发生率。
ObjectiveSentinel node biopsy alone (SNB) reduces the postoperative complications of pelvic lymphadenectomy, such as lymphedema and lymphangitis; however, the long-term prognosis after SNB is unclear. The objective of this study was to evaluate the long-term outcome and complications of patients with early-stage cervical cancer who underwent SNB for hysterectomy or trachelectomy.MethodsWe performed SNB for cervical cancer using a radioisotope method in 181 patients between 2009 and 2017. If the intraoperative sentinel lymph node evaluation was negative for metastasis, no further lymph nodes were removed.ResultsThe median age of the patients was 34 years (range, 21–73 years). The International Federation of Gynecology and Obstetrics 2008 stage was IA1 in 6 patients, IA2 in 18, IB1 in 154, and IIA1 in 3. Of the 181 patients (44 with hysterectomy, 137 with trachelectomy), 8 did not undergo pelvic lymphadenectomy because of a false-negative intraoperative diagnosis, 20 received adjuvant therapy after surgery, and 4 (2.2%) experienced recurrence over a median follow-up period of 83.5 months (range, 25–145 months). In the four recurrent cases, recurrence occurred in the pelvis, lung, and bone in one patient each, while the remaining patient developed pelvic and para-aortic lymph node metastases. Of these four patients, one died, and the remaining three are alive without disease after multidisciplinary therapy. The 5-year progression-free and overall survival rates were 98.8% and 99.4%, respectively. Postoperative complications, such as lymphedema, were very low rate.ConclusionsSNB for early-stage cervical cancer might be safe and effective, with no increase in the recurrence and postoperative complications rate.