IMR Press / EJGO / Volume 25 / Issue 3 / pii/2004177

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Original Research

Sentinel node identification and intraoperative lymphatic mapping. First results of a pilot study in patients with endometrial cancer

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1 Department of Gynaecology, University of Tuebingen, Tuebingen (Germany)
2 Department of Gynaecology, University of Luebeck, Luebeck (Germany)
3 Department of Gynaecology, University Marburg, Marburg (Germany)
Eur. J. Gynaecol. Oncol. 2004, 25(3), 339–342;
Published: 10 June 2004

Introduction: To minimize the surgical morbidity after lymphadenectomy, sentinel node biopsy (SLNB) has become fundamen­tal in the management of different malignancies. We decided to evaluate sentinel lymph node (SNL) biopsies also in patients with endometrial cancer undergoing hysterectomy with lymphadenectomy. Methods: In the setting of a prospective study we developed a technique for sentinel node biopsy of ten patients with histologi­cally confirmed endometrial cancer. Prior to surgery 99m Tc Nanocol® was injected in the peritumoral region by hysteroscopy. Six hours later lymphoscintigraphy was performed to identify the draining lymph nodes. During surgery we first detected the sentinel lymph node by a hand-held gamma tracer and then removed it. Surgery was completed by the standard therapy of total hysterec­tomy, bilateral salpingo-oophorectomy and pelvic and/or para-aortic lymphadenectomy. Results: Scintigraphic identification was possible in eight out of ten patients. Intraoperative identification of sentinel lymph nodes was possible in seven out of eight patients. In five patients we found the sentinel lymph nodes in the pelvic region while the other two patients had bilateral sentinel nodes in the pelvic and para-aortic region. Histologically confirmed microscopic tumor metas­tases of the SLNs and para-aortic lymph nodes were only found in one case. The sentinel lymph nodes from the other six patients were free of tumor and accurately reflected the pathological status. Conclusion: The identification of sentinel lymph nodes in endometrial cancer is a practical and safe method. In order to improve this technique as a standard procedure for staging of endometrial cancer further studies with a larger number of patients have to be done.

Sentinel lymph node
Endometrial cancer
Lymphatic mapping
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