Evaluation of the sentinel lymph node algorithm with blue dye labeling for early-stage endometrial cancer in a multicentric setting.
Int J Gynecol Cancer
; 23(7): 1237-43, 2013 Sep.
Article
in En
| MEDLINE
| ID: mdl-23839245
ABSTRACT
OBJECTIVES:
Sentinel lymph node (SLN) removal may be a midterm between no and full pelvic dissection in early endometrial cancer. Whereas the use of blue dye alone in SLN detection has a poor accuracy, its integration in an SLN algorithm may yield better results and overcome hurdles such as the requirement of nuclear medicine facility.METHODS:
Sixty-six patients with clinical stage I endometrial cancer were prospectively enrolled in a multicentre study between May 2003 and June 2009. Patent blue was injected intraoperatively into the cervix. We retrospectively assessed the accuracy of a previously described SLN algorithm consisting of the following sequence (1) pelvic node area is inspected for removal of all mapped SLN and (2) excision of every suspicious non-SLN, (3) in the absence of mapping in a hemipelvis, a standard ipsilateral lymphadenectomy is then performed.RESULTS:
Sentinel nodes were identified in 41 patients (62.1%), mostly in interiliac and obturator areas. None was detected in the para-aortic area. Detection was bilateral in 23 cases (56.1%). Seven patients (10.6%) had positive nodes. The false-negative rate was 40% using SLN detection alone. When the algorithm was applied, the false-negative rate was 14.3%. The use of a SLN algorithm would have avoided 53% of lymphadenectomiesCONCLUSION:
Our multicentric evaluation validates the use of a SLN algorithm based on blue-only sentinel node mapping in early-stage endometrial cancer. The application of such SLN algorithm should be evaluated in a prospective context and might lead to decrease unnecessary lymphadenectomies.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Rosaniline Dyes
/
Adenocarcinoma, Papillary
/
Endometrial Neoplasms
/
Cystadenocarcinoma, Serous
/
Adenocarcinoma, Clear Cell
/
Sentinel Lymph Node Biopsy
/
Lymph Node Excision
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Int J Gynecol Cancer
Journal subject:
GINECOLOGIA
/
NEOPLASIAS
Year:
2013
Type:
Article
Affiliation country:
France