About this Research Topic
In the past years, the detection of sentinel lymph nodes (SLN) has established itself in the practice of endometrial and uterine early-stage tumors management as an alternative to the systematic lymphadenectomy. This technique finds its pathophysiological rationale according to which cancer cells spread from the primitive tumor to the lymph nodes in accordance with the progressive pattern from the nearest station to the furthest, without station jumps. Therefore, by removing the sentinel lymph node, it is possible to obtain information on the state of the entire lymph node chain, maintaining high oncological standards and minimizing the morbidity associated with lymphadenectomy.
The identification of sentinel lymph nodes increases the probability to identify the so-called micrometastases (tumor deposits <2mm) and isolated tumor cells (ITCs) (<0.2mm) that are difficult to detect through standard pathological evaluations. Despite the sentinel lymph node identification, its been shown to be correct and optimal in more than 90% of cases and is predictive of approximately 98%, there isn’t enough evidence on micrometastases or ITCs impact on progression-free survival of patients with uterine early-stage tumors.
For all these reasons, although this procedure was recently proposed by the National Comprehensive Cancer Network as an alternative to complete pelvic lymphadenectomy (category IIBC), more long-term experiments and data are needed to further appreciate real clinical benefits of sentinel node biopsy and to better understand the beneficial effects in uterine cancer patients.
The aim of the Research Topic is to provide an update on the latest clinical data and promote prospective multicentric sentinel node trials to highlight the pros and cons of the application of the sentinel node method in gynecological malignancies. We welcome submissions of Original Research, Review and Opinion articles, focusing on but not limited to the following topics:
1) The role of sentinel node biopsy in endometrial cancer
2) The role of sentinel node biopsy in cervical cancer
3) Pathological intraoperative examination of sentinel nodes
4) Sentinel node analysis: pathological ultra-staging methods (on permanent sections)
5) One-step nucleic acid (OSNA) molecular assay experience
6) The prognostic impact of ITC and micrometastases
Keywords: sentinel node, endometrial carcinoma, cervical carcinoma, intraoperative surgical staging
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