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Choose OSNA for lymph node assessment beyond ultra-staging
The current trend in disease management of early stage endometrial (EC) and cervical cancer (CeC) patients is to reduce the extent of surgery by applying sentinel lymph node biopsy (SLNB) instead of systematic lymphadenectomy.
SLNB enables intraoperative assessment of the nodal status by analysing a small number of lymph nodes. Existing methods using frozen sections lack sensitivity because only small parts of each SLN are examined, which risks missing small metastasis in other parts of the nodes. On the other side, more comprehensive serial sectioning is time-consuming and laborious, which is unsuitable in an intraoperative setting.
OSNA (one step nucleic acid amplification) is an optimal solution to overcome such limitations. OSNA is a rapid, highly sensitive and standardised molecular method which allows analysis of the entire SLN intraoperatively. This enables surgeons to have fully informed results so they can make immediate decisions on the most suitable surgical approach for a patient, to potentially reduce surgical radicality and to avoid unnecessary lymphadenectomies.
Accurate intraoperative lymph node analysis with OSNA supports de-escalation of surgical radicality
Most men undergoing surgery will have not only their prostate removed, but also the pelvic lymph nodes (LN) in order to eliminate any potential source of tumour cells. While the removal of the prostate is associated with risks of urinary and erectile dysfunctions, the removal of the adjacent LNs increases the chances of lymphatic drainage dysfunctions.
However, in some 70-90% of early stage patients the tumour is confined to the prostate, making the extra burden of the node dissection curatively pointless.
Could extensive LN dissection and related morbidity be spared in these men?
Pioneer groups in the field of prostate cancer advocate innovative, less invasive treatment approaches by reducing the number of LNs that are removed to a bare minimum. Namely the sentinel lymph node biopsy, a well-stablished method in several other malignancies; here, only the node(s) most prone to carry metastasis are removed and analysed4-6.
The OSNA molecular diagnostic test has been successfully supporting the accurate analysis of sentinel LNs in breast cancer patients worldwide for over 10 years. As of 2020, OSNA technology is also available for prostate cancer patients. OSNA provides fast and accurate results intraoperatively, thus supporting de-escalation of surgery and potentially improving prostate cancer patients’ quality of life.