Predictors of Non-Sentinel Lymph Node Metastasis in Patients with Positive Sentinel Lymph Node in Early-Stage Cervical Cancer: A SENTICOL GROUP Study

Basile Pache; Matteo Tantari; Benedetta Guani; Patrice Mathevet; Laurent Magaud; Fabrice Lecuru; Vincent Balaya; SENTICOL Group

doi:10.3390/cancers15194737

Predictors of Non-Sentinel Lymph Node Metastasis in Patients with Positive Sentinel Lymph Node in Early-Stage Cervical Cancer: A SENTICOL GROUP Study

Cancers (Basel). 2023 Sep 26;15(19):4737. doi: 10.3390/cancers15194737.

Authors

Basile Pache^{1

2

3}, Matteo Tantari⁴, Benedetta Guani^{2

3}, Patrice Mathevet^{1

2}, Laurent Magaud⁵, Fabrice Lecuru⁶, Vincent Balaya^{7

8}; SENTICOL Group

Affiliations

¹ Department Women-Mother-Child, Gynecology and Obstetrics Unit, Lausanne University Hospital (CHUV), 1005 Lausanne, Switzerland.
² University of Lausanne (UNIL), 1015 Lausanne, Switzerland.
³ Gynecology Department, Fribourg University Hospital, University of Fribourg, 1700 Fribourg, Switzerland.
⁴ Unit of Obstetrics and Gynecology, Ospedale Villa Scassi-ASL3, Metropolitan Area of Genoa, 16149 Genoa, Italy.
⁵ Clinical Research and Epidemiology Department, Public Health Center, Hospices Civils de Lyon, F-69003 Lyon, France.
⁶ Breast, Gynecology and Reconstructive Surgery Unit, Institut Curie, Paris University, F-75005 Paris, France.
⁷ Department of Obstetrics and Gynecology, Felix Guyon Hospital, University Hospital La Réunion, F-97490 Saint-Denis, France.
⁸ University of La Réunion, F-97744 Saint-Denis, France.

Abstract

Background: The goal of this study was to identify the risk factors for metastasis in the remaining non-sentinel lymph nodes (SLN) in the case of positive SLN in early-stage cervical cancer.

Methods: An ancillary analysis of two prospective multicentric databases on SLN biopsy for cervical cancer (SENTICOL I and II) was performed. Patients with early-stage cervical cancer (FIGO 2018 IA to IIA1), with bilateral SLN detection and at least one positive SLN after ultrastaging, were included.

Results: 405 patients were included in SENTICOL I and Il. Fifty-two patients had bilateral SLN detection and were found to have SLN metastasis. After pelvic lymphadenectomy, metastatic involvement of non-SLN was diagnosed in 7 patients (13.5%). Patients with metastatic non-SLN were older (51.9 vs. 40.8 years, p = 0.01), had more often lympho-vascular space invasion (LVSI) (85.7% vs. 35.6%, p = 0.03), and had more often parametrial involvement (42.9% vs. 6.7%, p = 0.003). Multivariate analysis retained age (OR = 1.16, 95% IC = [1.01-1.32], p = 0.03) and LVSI (OR = 25.97, 95% IC = [1.16-582.1], p = 0.04) as independently associated with non-SLN involvement.

Conclusions: Age and LVSI seemed to be predictive of non-SLN metastasis in patients with SLN metastasis in early-stage cervical cancer. Larger cohorts are needed to confirm the results and clinical usefulness of such findings.

Keywords: SENTICOL; cervical cancer; pelvic lymphadenectomy; sentinel lymph node; ultrastaging.

Grants and funding

This work was supported by clinical research grant No. AOR 03063 to the French National Hospital Clinical Research Project, by the French National Cancer Institute (INCA), and by the “Soutien aux Technologies et Innovations Coûteuses” (STIC RCT 01639820 2008).