Publications Update # 12

Publications Update # 12
Photo by Kenny Eliason / Unsplash

Non-Medical Article of the Week

We all have to give presentations. Some are not as high stakes as others - teaching med students/residents vs. departmental or invited Grand Rounds. Nevertheless, every presentation is an opportunity to improve your skills. There are plenty of materials available on the internet. If you already have favorite articles or videos that work for you, great. If not, here are a few you might want to archive in your collection to refer to when you are about to give a presentation.

What It Takes to Give a Great Presentation
Never underestimate the power of great communication. It can help you land the job of your dreams, attract investors to back your idea, or elevate your stature within your organization. But while there are plenty of good speakers in the world, you can set yourself apart out by being the person who c…

If you have an hour to spare, this video by Prof. Patrick Winston (a computer scientist at MIT) is my favorite presentation on giving great presentations.

Endometrial Cancer

Sentinel lymph node dissections is now the standard of care for endometrial cancer in most developed countries. The FIRES trial established that the sentinel lymph node dissection had a sensitivity of 97% and a negative predictive value of 99·6%. Furthermore, the SENTOR study established that SLND is a viable option in high-grade endometrial cancer. Although most surgeons agree on using the sentinel lymph node technique for low-grade endometrial cancer, some centers still perform full lymph node dissection in high-grade endometrioid and type II endometrial cancers. Two prospective randomized trials to compare the oncologic outcomes of SLND vs. full lymph node dissection in high-risk endometrial cancer are underway, but the results are expected in 2027 and 2031, respectively.

Sentinel lymph node mapping versus sentinel lymph node mapping with systematic lymphadenectomy in endometrial cancer: an open-label, non-inferiority, randomized trial (ALICE trial)
Background Growing evidence suggest that sentinel lymph node (SLN) biopsy in endometrial cancer accurately detects lymph node metastasis. However, prospective randomized trials addressing the oncological outcomes of SLN biopsy in endometrial cancer without lymphadenectomy are lacking. Primary Objec…
A phase III randomized clinical trial comparing sentinel node biopsy with no retroperitoneal node dissection in apparent early-stage endometrial cancer – ENDO-3: ANZGOG trial 1911/2020
Background Sentinel node biopsy is a surgical technique to explore lymph nodes for surgical staging of endometrial cancer, which has replaced full retroperitoneal lymph node dissection. However, the effectiveness of sentinel node biopsy, its value to patients, and potential harms compared with no-no…

However, there are several retrospective reviews supporting the oncologic safety of SNLD in this patient population. A non-exhaustive list includes these articles:

Long-term survival outcomes in high-risk endometrial cancer patients undergoing sentinel lymph node biopsy alone versus lymphadenectomy - PubMed
Sentinel lymph node mapping alone in high-risk endometrial cancer appears to be an oncologically safe technique over a long observational time. Systematic lymphadenectomy in this population does not offer a survival advantage.
Multicenter study comparing oncologic outcomes after lymph node assessment via a sentinel lymph node algorithm versus comprehensive pelvic and paraaortic lymphadenectomy in patients with serous and clear cell endometrial carcinoma - PubMed
OS was not compromised with the SLN algorithm. SLN may be associated with a decreased RFS but similar OS in node-negative cases despite the majority receiving chemotherapy. This may be due to differences in surveillance.
Sentinel lymph node mapping alone compared to more extensive lymphadenectomy in patients with uterine serous carcinoma - PubMed
SLN mapping alone and systematic LND yielded similar survival outcomes in stage I-III USC. In our practice, the SLN algorithm has replaced systematic LND as the primary staging modality in this setting.