AT THE ANNUAL MEETING ON WOMEN’S CANCER
NATIONAL HARBOR, MD. – Patients with endometrial cancer and isolated tumor cells in sentinel lymph nodes had excellent short-term outcomes, even if they opted out of adjuvant chemotherapy or radiation therapy.
In a single-center prospective study, all 10 such patients remained alive and free of disease progression at 3 years, Marie Plante, MD, said in a video interview at the annual meeting of the Society of Gynecologic Oncology.
The finding suggests that isolated tumor cells in sentinel lymph nodes are not, by themselves, an indication for adjuvant therapy in women with endometrial cancer, said Dr. Plante of Laval University in Quebec City. The issue remains controversial, however, and merits larger cohort studies with longer-term follow-up, she acknowledged.
Ultrastaging of sentinel lymph node biopsies that are negative on hematoxylin and eosin staining has boosted the detection of low-volume metastases. In the case of endometrial cancer with isolated tumor cells, there is a dilemma about whether to recommend adjuvant therapy. Very few studies have examined this relatively rare patient subgroup.
This study included 519 patients undergoing hysterectomy, salpingo-oophorectomy, lymphadenectomy, and sentinel lymph node mapping for endometrial cancer. Pathologic ultrastaging identified 31 patients with isolated tumor cells (6%), of whom 11 received adjuvant chemotherapy, 14 received pelvic radiation therapy, and 10 received brachytherapy or observation only.
Only one patient with isolated tumor cells developed recurrent disease within 3 years. This patient had a 7-cm carcinosarcoma that recurred despite adjuvant chemotherapy and radiation therapy. There were no recurrences among patients with endometrioid histology, Dr. Plante noted.
Dr. Plante cited no funding sources and reported having no conflicts of interest.