Comparison of two procedures for sentinel lymph node detection in patients with endometrial cancer: a pilot study

• Published in: European journal of gynaecological oncology Vol. 23; no. 1; p. 53
• Main Authors: Holub, Z, Jabor, A, Kliment, L
• Format: Journal Article
• Language: English
• Published: Italy 2002
• Subjects: Aged; Chi-Square Distribution; Coloring Agents; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Female; Humans; Hysterectomy - methods; Laparoscopy - methods; Lymph Node Excision - methods; Lymphatic Metastasis - pathology; Middle Aged; Neoplasm Staging - methods; Pilot Projects; Probability; Sensitivity and Specificity; Sentinel Lymph Node Biopsy - methods; Statistics, Nonparametric
• ISSN: 0392-2936

The purpose of this study was to assess the feasibility and contribution of two intraoperative procedures of lymphatic mapping and sentinel node detection using a blue dye in surgically-staged patients with early stage endometrial cancer. In 25 cases of endometrial cancer, patent blue-V was injected into the subserosal myometrium (13 cases, SM group) or cervico-subserosal myometrium (12 cases, CSM group) during a surgical staging procedure. Laparoscopically-assisted vaginal hysterectomy and pelvic lymphadenectomy were completed successfully in 23 women out of 24 laparoscopically-staged patients (95.8%). One patient with FIGO stage IIa was indicated for a radical abdominal surgery. A deposition of the blue dye was found in at least one pelvic lymph node (LN) in eight out of 13 cases (61.5%) in the SM group compared with ten out of 12 cases (83.3%) in the CSM group (p = 0.378). The mean number of dye-colored LN (DCLN) was 1.15 (SM group) and 2.5 (CSM group), respectively (p = 0.05). The rate of DCLN/LN was 15/188 (SM group) versus 30/190. respectively (p = 0.03). An uptake of the blue bye was observed in a total of 45 out of 388 LN. An intraoperative combination of cervico-subserosal myometrium application of the blue dye allows successful detection (83.3%) of sentinel LN in patients with endometrial cancer. Comparing SM and CSM groups the statistical significant difference was found in the DCLN/LN rate and mean number of sentinel lymph nodes (p = 0.03, p = 0.05, respectively). Clinical validity of this surgical procedure must be assessed prospectively.