SynthesisFrontiers in medicine2025
Prognostic impact of low-volume nodal metastases in endometrial cancer: a systematic review of molecular subtypes.
Synthesis in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- A novel nomogram incorporating preoperative systemic inflammatory response index and clinicopathological parameters for predicting lymph node metastasis in endometrial cancer.Frontiers in oncology · 2026Article
- Oncologic safety of sentinel lymph node-based nodal de-escalation in apparent uterine-confined endometrial cancer: a multicenter international cohort study.Frontiers in oncology · 2026Article
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Authors and funding
1 author.
Funding
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Abstract
Introduction: Endometrial cancer (EC) is the most common gynecologic malignancy, with lymph node metastases (LNM) serving as a key prognostic factor. Low-volume metastases (LVM), including micrometastases (MM; >0.2-≤2 mm) and isolated tumor cells (ITCs; ≤0.2 mm), detected via sentinel lymph node (SLN) ultrastaging, remain controversial regarding their clinical impact. This systematic review evaluates the prognostic significance of LVM, stratified by The Cancer Genome Atlas (TCGA) molecular subtypes. Methods: Following PRISMA guidelines, this study conducted a systematic review (PROSPERO: CRD420251067512) of research published from 2013 to 2025. Inclusion criteria comprised EC patients with LVM who underwent nodal staging (SLN or lymphadenectomy) and molecular classification. Outcomes included progression-free survival (PFS), overall survival (OS), recurrence, and the impact of adjuvant therapy. Risk of bias was assessed using the Newcastle-Ottawa Scale and ROBINS-I. Results: Ten studies ( Discussion: The prognostic relevance of LVM varies substantially by metastatic burden and molecular subtype. Micrometastases may warrant escalation of adjuvant therapy, whereas ITCs may not require systemic treatment in favorable molecular subtypes. SLN ultrastaging should be standardized, and integration of TCGA classification into routine clinical decision-making is essential. Future clinical trials must validate subtype-specific management strategies. Systematic review registration: PROSPERO, identifier ID: CRD420251067512.
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