OBJECTIVE: The current study aimed to analyze predictive factors of sentinel lymph node mapping failure in apparently early stages of endometrial cancer using intracervical indocyanine green injection. METHODS: A single-center prospective study was conducted between June 2019 and August 2023 at the Department of Gynecology and Obstetrics, University Hospital Brno, Czech Republic. All patients with apparently early stage (I or II according to FIGO [International Federation of Gynecology & Obstetrics] 2009) endometrial cancer, who were indicated for sentinel node biopsy were consecutively included. The injection of 4-6 mL of indocyanine green was applied superficially and deeply into cervical tissue at the 3- and 9-o'clock positions. Patients' clinical data, surgical characteristics, and histopathological information were recorded. Univariable and multivariable regression analyses were applied. RESULTS: A total of 225 patients were eligible during the study period. Considering bilateral and unilateral failed mapping together, the only statistically significant factors for risk of failure in univariable analysis were body mass index (BMI; P = 0.036), FIGO 2009 stage (P = 0.019), and the presence of a myoma (P = 0.017). Nevertheless, when the multivariable logistic regression analysis was applied, all factors became statistically insignificant except for myoma (P = 0.031). Regarding only bilateral mapping failure, in univariable analysis, BMI (P = 0.021) and FIGO 2009 stage (P = 0.046) were significant predictors of failure. Interestingly, multivariable logistic regression analysis revealed that in addition to BMI (P = 0.007), age (P = 0.004) was also an independent predictor of bilateral failure. CONCLUSIONS: Higher BMI and age were statistically significant independent factors for bilateral sentinel node mapping failure in early-stage endometrial cancer.

• Klíčová slova
• biopsy, endometrial cancer, myomas, obesity, sentinel lymph node,
• MeSH
• barvicí látky * aplikace a dávkování   MeSH
• biopsie sentinelové lymfatické uzliny * metody   MeSH
• dospělí MeSH
• index tělesné hmotnosti MeSH
• indokyanová zeleň * aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• nádory endometria * patologie   chirurgie   MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• sentinelová uzlina * patologie   MeSH
• staging nádorů MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• barvicí látky * MeSH
• indokyanová zeleň * MeSH

INTRODUCTION AND OBJECTIVES: Patients with clinically node-positive (cN+) bladder cancer (BCa) form a biologically and prognostically diverse group. As systemic therapy reshapes management in this setting, this study examines oncological outcomes after radical cystectomy (RC) with or without perioperative systemic therapy. MATERIALS AND METHODS: We utilized a multicenter, retrospectively collected database of 1067 patients diagnosed with cTanyN+M0 BCa who underwent RC with lymphadenectomy with or without perioperative systemic treatment. Patients with cN1-2 disease and treated from 2006 and 2023 were included. Three-months landmark Kaplan-Meier curves were used to estimate the overall survival (OS). Three-months landmark competing risk cumulative incidence curves were used to estimate the cancer specific mortality (CSM). Multivariable Cox regression models (MCR) were used to assess the association of treatment and pathology response (complete response [pCR], partial response [pPR] and pN0) with any cause death and cancer specific death. RESULTS: A total of 589 patients met the inclusion criteria, with 189 (32%) receiving preoperative systemic treatment (PST) and 115 (20%) undergoing RC + adjuvant therapy (AT). Median follow-up was 32 months. Three-year OS was 69% for PST + RC, 55% for RC + AT, and 55% for RC alone. PST + RC (HR: 0.67, P = .042) was associated with a lower risk of all-cause mortality at MCR. The 3-year CSM was 28% for PST + RC, 38% for RC + AT, and 32% for RC alone. Achieving pCR (HR: 0.31, P = .004), pPR (HR: 0.35, P < .001), and pN0 (HR: 0.44, P < .001) was associated with significantly lower risks of both all-cause and cancer-specific mortality. CONCLUSIONS: Patients with cN+ BCa undergoing surgery show varied oncological outcomes. Those receiving PST and AT had longer OS, highlighting the importance of systemic therapy. The prognostic value of pCR, pPR, and pN0 supports the need for refined risk stratification to guide preoperative treatment and personalize care.

• Klíčová slova
• Muscle invasive bladder cancer, Overall survival, Pelvic lymph node dissection, Perioperative systemic therapy, Urothelial carcinoma,
• MeSH
• cystektomie * metody   MeSH
• Kaplanův-Meierův odhad MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfadenektomie MeSH
• lymfatické metastázy MeSH
• lymfatické uzliny patologie   chirurgie   MeSH
• nádory močového měchýře * patologie   mortalita   chirurgie   terapie   MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

The objective of this study is to undertake a narrative review of the oncological adequacy of mediastinal lymphadenectomy performed via robot-assisted thoracic surgery (RATS) in comparison with video-assisted thoracic surgery (VATS) and thoracotomy for non-small cell lung cancer (NSCLC). The focus of the review is on lymph node yield, nodal station dissection, and nodal upstaging rates. A narrative review of literature published in the last decade was conducted using PubMed, Cochrane, and Web of Science databases. Studies examining mediastinal lymphadenectomy outcomes for RATS, VATS, or thoracotomy were included in the discussion. The analysis of 19 studies from diverse geographical regions showed that in six out of nine comparative studies, RATS demonstrated superior lymph node retrieval compared to VATS, with statistically significant differences. RATS achieved comparable or superior nodal station dissection rates and showed particular advantages in upstaging from clinical N0 to pathological N2 status. Additionally, RATS demonstrated favourable perioperative outcomes with reduced morbidity and mortality rates compared to conventional approaches. RATS represents a reliable and oncologically sound approach to mediastinal lymphadenectomy, with potential advantages over conventional techniques. Its enhanced visualization and precision make it an increasingly utilised option for NSCLC treatment in centres with robotic capabilities.

• Klíčová slova
• Lung cancer, Mediastinal lymphadenectomy, Robotic-assisted surgery, Summary, Thoracic surgery,
• MeSH
• hrudní chirurgie video-asistovaná metody   MeSH
• lidé MeSH
• lymfadenektomie * metody   MeSH
• mediastinum chirurgie   MeSH
• nádory plic * chirurgie   patologie   MeSH
• nemalobuněčný karcinom plic * chirurgie   patologie   MeSH
• roboticky asistované výkony * metody   MeSH
• torakotomie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

INTRODUCTION: Retroperitoneal lymph node dissection (RPLND) is crucial in managing metastatic germ cell tumors (GCTs), particularly post-chemotherapy. Given the long-term survival of these patients, perioperative morbidity is a significant concern. However, data on RPLND morbidity using predefined reporting standards are scarce. This study aims to address this gap by utilizing updated European Association of Urology (EAU) guidelines for standardized complication reporting. PATIENTS AND METHODS: A retrospective analysis was conducted on patients who underwent RPLND for GCTs between 2010 and 2022. 30-day complications were extracted from digital charts using a predefined procedure-specific catalog. Complications were graded using the Clavien-Dindo classification (CDC), and the Comprehensive Complication Index (CCI) was calculated for each patient. RESULTS: Sixty-nine men underwent RPLND at a median age of 32 years (IQR 25-38). Chemotherapy was administered to 64 patients (93 %), with 48 (70 %) having negative tumor markers. Median tumor diameter was 52 mm (IQR 35-83), and median operative time was 197 min (IQR 128-262). Unilateral template removal was performed in 55 patients (80 %). A total of 157 complications were reported in 66 patients (96 %), with anemia (33 %) and gastrointestinal issues (24 %) being the most common. Five patients (7.2 %) had "major" complications (CDC grade ≥ IIIa), and the median CCI was 12 (IQR 9-23). Using the CCI, the proportion of patients with a "major" complication burden increased to 14 %, compared to 8.5 % by CDC alone. The primary limitation of this study is its retrospective design and the limited 30-day follow-up period. CONCLUSION: Most patients experience postoperative complications after RPLND, though severe complications are rare. These findings could improve patient counseling when discussing testicular cancer therapy options.

• Klíčová slova
• Clavien-Dindo classification, Comprehensive Complication Index, Guideline adherence, Lymph node excision, Postoperative complications, Testicular neoplasms,
• MeSH
• dospělí MeSH
• germinální a embryonální nádory * chirurgie   patologie   MeSH
• lidé MeSH
• lymfadenektomie * škodlivé účinky   MeSH
• morbidita MeSH
• následné studie MeSH
• pooperační komplikace * epidemiologie   etiologie   MeSH
• prognóza MeSH
• retroperitoneální prostor chirurgie   patologie   MeSH
• retrospektivní studie MeSH
• směrnice pro lékařskou praxi jako téma * normy   MeSH
• testikulární nádory * chirurgie   patologie   MeSH
• urologie normy   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• scoping review MeSH

INTRODUCTION: The substantial improvement in early-stage cervical cancer survival rates has given rise to the significance of subsequent quality of life. This study aims to assess the quality of life in patients subjected to radical and conservative surgeries for cervical cancer. MATERIALS AND METHODS: One hundred patients diagnosed with early-stage cervical cancer (stages IA2-IIA1) undergoing surgical treatment were enrolled in our study between 2007 and 2011. Patients completed quality of life questionnaires EORTC QLQ-C30 and QLQ-CX24, distributed before the surgery, 6, 12, and 120 months after the procedure. At the final 120-month follow-up, 54 patients remained eligible for inclusion. 23 patients ("CONS group") underwent laparoscopic lymphadenectomy combined with hysterectomy or simple trachelectomy. The remaining 31 patients ("RAD group") underwent abdominal radical hysterectomy type C1. RESULTS: At the 6-month post-surgery assessment, the RAD group reported a significantly higher incidence of menopausal symptoms, decline in physical functioning and concern regarding their sexual well-being. CONS group patients reported notable exacerbation of lymphedema and neuropathy-related symptoms but only a slight decline in physical functioning. Additionally, their role functioning, emotional well-being, and social functioning significantly improved compared to their preoperative baseline. At the 120-month postoperative assessment the RAD group showed a significant decline in several parameters, including lymphedema, peripheral neuropathy, postmenopausal symptoms, fatigue, pain, and physical functioning. CONCLUSIONS: Cervical cancer treatment is invariably associated with a negative long-term impact on quality of life, RAD group demonstrated poorer outcomes than the CONS group across multiple parameters but even the CONS group exhibited long-term effects of the surgery.

• MeSH
• dospělí MeSH
• hysterektomie * metody   škodlivé účinky   MeSH
• kvalita života * MeSH
• laparoskopie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfadenektomie metody   škodlivé účinky   MeSH
• lymfedém etiologie   epidemiologie   MeSH
• nádory děložního čípku * chirurgie   patologie   psychologie   MeSH
• následné studie MeSH
• pooperační komplikace MeSH
• pooperační období MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• staging nádorů MeSH
• trachelektomie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Supraglottic squamous cell carcinoma (SCC) is a significant portion of head and neck cancers, with the management of clinically negative necks (cN0) through selective neck dissection (SND) being debated due to potential morbidities and low metastasis rates in levels IIb and IV. METHODS: This study is a retrospective, multicenter examination of the potential feasibility of limited neck dissection (LND), including only levels IIa and III in cN0 supraglottic SCC patients. It analyzed occult metastasis rates and explored relapse occurrences alongside potential predictors of lymph node metastasis. RESULTS: Among 425 patients, predominantly male (85.6%) with a mean age of 63 years, the occult metastasis rate was 28.9%, and 13.7% experienced relapses during a mean follow-up of 52 months. Advanced clinical stage, higher grading, and other risk factors emerged as predictors of occult lymph node metastasis at level IIb. CONCLUSIONS: The study supports LND potential feasibility for cN0 supraglottic SCC, suggesting level IIb dissection can be omitted in specific early-stage cases to reduce morbidity without affecting outcomes.

• Klíčová slova
• clinically negative neck, larynx, limited neck dissection, occult metastasis, supraglottis,
• MeSH
• dospělí MeSH
• krční disekce * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru patologie   MeSH
• lymfatické metastázy MeSH
• nádory hrtanu * patologie   chirurgie   mortalita   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spinocelulární karcinom * chirurgie   patologie   mortalita   MeSH
• staging nádorů MeSH
• studie proveditelnosti MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

Due to the implementation of sentinel lymph node ultrastaging, the prevalence of isolated tumor cells and micrometastases have increased. This literature review comprises of articles published between January 2019 and September 2024 aiming at low-volume metastases in regional lymph nodes, their prognosis, and links to molecular classification. Micrometastases are currently considered as having metastatic lymph node involvement; however, they have a better prognosis than macrometastases. Accordingly, therapy is tailored. In contrast, isolated tumor cell presence is not considered metastatic involvement according to International Federation of Gynecology and Obstetrics (FIGO) 2023 staging and does not affect the therapeutic procedure because their significant prognostic importance has not been proven so far.

• Klíčová slova
• endometrial cancer, isolated tumor cells, low-volume metastasis, micrometastases, sentinel lymph node, ultrastaging,
• MeSH
• biopsie sentinelové lymfatické uzliny MeSH
• lidé MeSH
• lymfatické metastázy * patologie   MeSH
• lymfatické uzliny * patologie   MeSH
• mikrometastázy MeSH
• nádory endometria * patologie   terapie   MeSH
• prognóza MeSH
• sentinelová uzlina patologie   MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Preoperative tumour size is a key prognostic marker in tailoring surgical treatment in early-stage cervical cancer. This post-hoc analysis assessed the accuracy of preoperative tumour size evaluation via imaging, utilizing data from the prospective, international, multicentre SENTIX study that evaluated safety of sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. METHODS: Between 05/2016-09/2020, forty-seven sites across 18 countries enrolled cervical cancer patients (FIGO2018 stages 1A1/lymphovascular-space-invasion-positive to 1B2). Preoperative staging included pelvic MRI or ultrasound as mandatory imaging modalities. All patients underwent primary surgical treatment. Pathological assessment of surgical specimens served as reference standard for evaluating the accuracy of preoperative assessments. RESULTS: Among the 680 included patients, although the mean tumour size discrepancy between preoperative/pathological assessments was only 1.24 ± 8.891 mm, postoperative pT stage was upgraded in 187 (27.5 %) and downgraded in 74 (10.9 %) patients. Discrepancy of ≥10 mm was observed among 155 (22.8 %) patients across all stages, with underestimation in 105 (15.4 %), overestimation in 50 (7.4 %), and a positive correlation (P < 0.0001) between the pathological tumour size and the discrepancy in size assessment. If a maximum 2 cm tumour size threshold were applied to guide the decision between simple and radical hysterectomy, underestimation would result in inadequate surgical management for 9.0 % of patients, whereas overestimation would lead to unnecessarily radical procedures in 5.1 % of cases. CONCLUSIONS: The study highlights, that even with the use of modern imaging in preoperative staging, inaccuracies in tumour size assessment remain a common cause of up-/down-staging after surgery resulting in potential inappropriate planning of surgery, and thus in procedure that is either excessively or insufficiently radical. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02494063.

• Klíčová slova
• Cervical cancer, Clinical staging, FIGO, Guidelines, MRI, Preoperative staging, TNM, Tumour size, Ultrasound,
• MeSH
• biopsie sentinelové lymfatické uzliny metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory děložního čípku * patologie   chirurgie   diagnostické zobrazování   MeSH
• předoperační péče metody   MeSH
• prospektivní studie MeSH
• senioři MeSH
• staging nádorů MeSH
• tumor burden MeSH
• ultrasonografie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: This study aimed to evaluate the effectiveness of different tracers´ application techniques for sentinel lymph node (SLN) detection in women with endometrial cancer undergoing laparotomy. Additionally, potential risk factors for SLN detection failure were assessed. METHODS: We retrospectively analyzed data from 248 endometrial cancer patients who underwent abdominal surgery with SLN mapping between January 2020 and March 2024. Statistical analyses were conducted using the Wilcoxon rank sum test for continuous variables and either Pearson's chi-square test or Fisher's exact test for categorical variables, with a significance level set at p < 0.05. RESULTS: Group I + S consisted of 147 women with intracervical and subserosal tracers´application and group I + I included 101 women with intracervical and intrafundal application. Successful detection of SLN on both sides was achieved in 39.9% (99/248) of all patients, in 38.1% (56/147) in the I + S group and in 42.6% (43/101) in the I + I group, respectively. SLNs were identified in 32.7% (81/248) of all patients on only one side of the pelvis, in 31.3% (46/147) in the I + S and in 34.7% (35/101) in the I + I group, respectively. No SLNs were detected in 27.4% (68/248) of all subjects, comprising 30.6% (45/147) from the I + S and 22.8% (23/101) from the I + I group. Although the success rate of SLN detection was higher in the I + I group and on the right side of the pelvis regardless of the detection method, these differences were not statistically significant. An age exceeding 66.3 years was recognized as a critical risk factor for successful detection, other followed factors did not demonstrate a statistically significant impact on overall detection success. Additional significant risk factors were identified: depth of tumor myometrial invasion on the right side, history of pelvic surgery, and total tumor volume on the left side. CONCLUSIONS: The study did not reveal significant differences in SLN mapping success between the groups receiving intracervical + intrafundal and intracervical + subserosal tracers´applications among endometrial cancer patients treated via open surgery. Overall, older age emerged as the most critical risk factor for SLN detection failure, while other assessed factors did not show a statistically significant impact on overall detection success. TRIAL REGISTRATION: Institution University Hospital Královské Vinohrady, Prague, Czech Republic. REGISTRATION NUMBER: EK-VP-21-0-2023. Date of registration 7-JUN-2023. This study was retrospectively registered in compliance with the Declaration of Helsinki.

• Klíčová slova
• Detection failure, Detection success, Endometrial cancer, Laparotomy, Risk factors, Sentinel lymph node, Tracer application,
• MeSH
• biopsie sentinelové lymfatické uzliny * metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• nádory endometria * chirurgie   patologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sentinelová uzlina * patologie   diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVES: SENTIX was a prospective, single-arm, international multicenter study that evaluated sentinel lymph node biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We aimed to evaluate the concordance between preoperative imaging modalities (magnetic resonance imaging (MRI) and ultrasound) and final pathology in the clinical staging of early-stage cervical cancer by post-hoc analysis of the SENTIX study data. METHODS: In total, 47 sites across 18 countries participated in the SENTIX study. Patients with Stage IA1/lymphovascular space invasion-positive to IB2 (International Federation of Gynecology and Obstetrics (FIGO) classification (2018)) cervical cancer, with usual histological types and no suspicious lymph nodes on imaging, were prospectively enrolled between May 2016 and October 2020. Preoperative pelvic clinical staging on either pelvic MRI or ultrasound examination was mandatory. Tumor size discrepancy (< 10 mm vs ≥ 10 mm) between imaging and pathology, as well as the negative predictive value (NPV) of MRI and ultrasound for parametrial involvement and lymph node macrometastasis, were analyzed. RESULTS: Among 690 eligible prospectively enrolled patients, MRI and ultrasound were used as the staging imaging modality in 322 (46.7%) and 298 (43.2%) patients, respectively. A discrepancy of tumor size ≥ 10 mm was reported between ultrasound and final pathology in 39/298 (13.1%) patients and between MRI and pathology in 53/322 (16.5%), with no significant difference in the accuracy of tumor measurement between the two imaging modalities. The NPV of ultrasound in assessing parametrial infiltration and lymph node involvement was 97.0% (95% CI, 0.95-0.99%) and 94.0% (95% CI, 0.91-0.97%), respectively, and that of MRI was 95.3% (95% CI, 0.93-0.98%) and 94.1% (95% CI, 0.92-0.97%), respectively, with no significant differences between the parameters. Ultrasound and MRI were comparable regarding the tumor size measurement (P = 0.452), failure to detect parametrial involvement (P = 0.624) and failure to detect macrometastases in sentinel lymph node (P = 0.876). CONCLUSIONS: Pelvic ultrasound examination and MRI had similar concordance with histology in the assessment of tumor size and of parametrial and lymph node invasion in early-stage cervical cancer. Ultrasound examination should be considered part of preoperative pelvic clinical staging in early-stage cervical cancer, especially in limited-resource regions where MRI is unavailable. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

• Klíčová slova
• FIGO, MRI, cervical cancer, clinical staging, imaging, ultrasound,
• MeSH
• biopsie sentinelové lymfatické uzliny MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické metastázy diagnostické zobrazování   MeSH
• lymfatické uzliny patologie   diagnostické zobrazování   MeSH
• magnetická rezonanční tomografie * metody   MeSH
• nádory děložního čípku * patologie   diagnostické zobrazování   MeSH
• pánev diagnostické zobrazování   patologie   MeSH
• prediktivní hodnota testů MeSH
• předoperační péče metody   MeSH
• prospektivní studie MeSH
• senioři MeSH
• staging nádorů metody   MeSH
• ultrasonografie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH