Диагностическая значимость лимфаденэктомии и биопсии сторожевого лимфоузла у пациенток с I и II стадией рака тела матки

Abstract

Objective of the Review: To present the advantages and disadvantages of LAE and SLN biopsy and to discuss the possibility of using SLN biopsy in all patients with early endometrial cancer. Key Points. For years, lymphadenectomy (LAE) has been a standard procedure which allowed determining the extent of neoplastic process and therapy in patients with endometrial cancer (EC). However, this procedure is very traumatic; besides, it does not impact the overall and disease-free survival and is associated with negative postoperative consequences. Introduction of the sentinel lymph node (SLN) biopsy made it possible to improve the rate of metastases detectability and to avoid LAE in patients with negative SLNs. For this review, we have analysed publications in Pubmed, UpToDate, Embase, and Cochrane Library for the period from 1998 to 2020. Pelvic LAE (both individual and in combination with para-aortic lymph nodes dissection) is still widely used in patients with an intermediate or high risk of lymphatic cancer spread. However, more and more specialists tend to believe that SLN is a more sensitive diagnostic method with a minimal rate of false negative results, allowing to single out best candidates for LAE. The high sensitivity of the method and absence of any negative consequences make it suitable for all patients, irrespective of the risk group. Conclusion. SLN biopsy is an optimal diagnostic method to identify the neoplastic process stage and a management strategy. However, all advantages and disadvantages of LAE and SLN biopsy should be analysed thoroughly taking into account the diagnostic significance of each method. Keywords: endometrial cancer, sentinel lymph node biopsy, lymphadenectomy, immune histochemical test.