The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series
Objective: Sentinel lymph node biopsy (SLNB) for endometrial cancer staging may identify isolated tumor cells (ITCs). Although guidelines do not classify nodes with ITCs as positive, earlier papers reported that a significant proportion of gynecologic oncologists treat ITCs as they would positive no...
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Elsevier
2025-04-01
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| Series: | Gynecologic Oncology Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578925000384 |
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| author | Camryn Kenkel Sarah S. Lee Naaman Mehta Jude Nawlo Edward Jimenez Leslie R. Boyd |
| author_facet | Camryn Kenkel Sarah S. Lee Naaman Mehta Jude Nawlo Edward Jimenez Leslie R. Boyd |
| author_sort | Camryn Kenkel |
| collection | DOAJ |
| description | Objective: Sentinel lymph node biopsy (SLNB) for endometrial cancer staging may identify isolated tumor cells (ITCs). Although guidelines do not classify nodes with ITCs as positive, earlier papers reported that a significant proportion of gynecologic oncologists treat ITCs as they would positive nodes. The objective of this study was to examine practice patterns and determine if the presence of ITCs in endometrial cancer affects adjuvant treatment decision-making. Methods: This was a retrospective series of patients with endometrial adenocarcinoma stages I to IIIB who underwent surgical staging with SNLB from July 2016 to January 2022 at three hospitals. The primary outcome of interest was the receipt of adjuvant treatment. Chi-square, Mann-Whitney U test, and logistic regression were used with significance set at p < 0.05. Results: Of seven hundred thirty-four patients included, ITCs were identified in 41 patients (5.6 %). Deep myometrial invasion (61.0 % vs 20.5 %, p < 0.001) and lymphovascular invasion (58.4 % vs 17.7 %, p < 0.001) were more common in patients with ITCs than in those with negative lymph nodes. Patients with ITCs were more likely to receive adjuvant treatment (30 of 41, 73.2 % vs 289 of 693, 41.7 %, p < 0.001). When controlling for age, stage, histology, grade, and lymphovascular space invasion, ITCs were not associated with an increased likelihood of adjuvant therapy receipt. Conclusions: Although patients with ITCs were more likely to receive adjuvant treatment, this was accounted for by other clinical and histological factors. Clinicians were likely to make decisions based on established risk factors, and more data are needed on the role of ITCs in the landscape of molecularly based decision making. |
| format | Article |
| id | doaj-art-1c9be0751bf44d2e95af9ef0b7de42ee |
| institution | OA Journals |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-1c9be0751bf44d2e95af9ef0b7de42ee2025-08-20T02:17:29ZengElsevierGynecologic Oncology Reports2352-57892025-04-015810171310.1016/j.gore.2025.101713The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case seriesCamryn Kenkel0Sarah S. Lee1Naaman Mehta2Jude Nawlo3Edward Jimenez4Leslie R. Boyd5New York University Grossman School of Medicine, New York, NY, United StatesDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, NYU Langone Health, New York, NY, United StatesDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, NYU Langone Health, New York, NY, United StatesDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, NYU Langone Health, New York, NY, United StatesDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, NYU Long Island, Mineola, NY, United StatesDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, NYU Langone Health. 240 E 38th St, 20th Floor, New York, NY 10016, United States; Corresponding author.Objective: Sentinel lymph node biopsy (SLNB) for endometrial cancer staging may identify isolated tumor cells (ITCs). Although guidelines do not classify nodes with ITCs as positive, earlier papers reported that a significant proportion of gynecologic oncologists treat ITCs as they would positive nodes. The objective of this study was to examine practice patterns and determine if the presence of ITCs in endometrial cancer affects adjuvant treatment decision-making. Methods: This was a retrospective series of patients with endometrial adenocarcinoma stages I to IIIB who underwent surgical staging with SNLB from July 2016 to January 2022 at three hospitals. The primary outcome of interest was the receipt of adjuvant treatment. Chi-square, Mann-Whitney U test, and logistic regression were used with significance set at p < 0.05. Results: Of seven hundred thirty-four patients included, ITCs were identified in 41 patients (5.6 %). Deep myometrial invasion (61.0 % vs 20.5 %, p < 0.001) and lymphovascular invasion (58.4 % vs 17.7 %, p < 0.001) were more common in patients with ITCs than in those with negative lymph nodes. Patients with ITCs were more likely to receive adjuvant treatment (30 of 41, 73.2 % vs 289 of 693, 41.7 %, p < 0.001). When controlling for age, stage, histology, grade, and lymphovascular space invasion, ITCs were not associated with an increased likelihood of adjuvant therapy receipt. Conclusions: Although patients with ITCs were more likely to receive adjuvant treatment, this was accounted for by other clinical and histological factors. Clinicians were likely to make decisions based on established risk factors, and more data are needed on the role of ITCs in the landscape of molecularly based decision making.http://www.sciencedirect.com/science/article/pii/S2352578925000384 |
| spellingShingle | Camryn Kenkel Sarah S. Lee Naaman Mehta Jude Nawlo Edward Jimenez Leslie R. Boyd The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series Gynecologic Oncology Reports |
| title | The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series |
| title_full | The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series |
| title_fullStr | The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series |
| title_full_unstemmed | The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series |
| title_short | The effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer: A retrospective case series |
| title_sort | effect of isolated tumor cells on adjuvant treatment decisions for patients with endometrial cancer a retrospective case series |
| url | http://www.sciencedirect.com/science/article/pii/S2352578925000384 |
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