216: Sentinel Node Detection of Endometrial Cancer, the Advantages of a New Needle for Injection of Tracers

Abstract

Study ObjectiveDetection of sentinel lymph nodes in endometrial cancer has recently been described by hysteroscopic injection of technetium-99 labeled colloids. The results of these studies seem to be promising, showing feasibility of the technique in endometrial carcinoma.InterventionIn our institute we performed hysteroscopic injection of technetium-99 labeled colloids using the 4 mm Bettocchi hysteroscope and a 5F diameter needle designed for this purpose. Three patients with an endometrial carcinoma diagnosed during office hysteroscopy were enrolled, after obtaining written consent, to participate in this preliminary study. The hysteroscopic injections were performed around the lesions, under the endometrium. Lymphoscintigraphic scans were performed after the injection of tracers. Twelve hours later, following total hysterectomy with bilateral salpyngo-oophorectomy, it was possible by means of radio-guided surgery to remove marked lymph nodes.Measurements and Main ResultsAll three hysteroscopic procedures were performed with the vaginoscopic approach and without patient discomfort. Injection of the tracers with the appropriate needle was easy to perform between the endometrium and the myometrium. Minimal pain was suffered by the patients when the needle touched the myometrium. Radio-guided surgery detected, in the first patient, three sentinel lymph nodes, in the second patient two lymph nodes and in the third patient four lymph nodes. All the lymph nodes resulted negative at the pathologic control.ConclusionThe sentinel lymph node technique has proven to be feasible in endometrial adenocarcinoma. Controlled studies are necessary to verify the true indications for the technique in this kind of cancer. Study ObjectiveDetection of sentinel lymph nodes in endometrial cancer has recently been described by hysteroscopic injection of technetium-99 labeled colloids. The results of these studies seem to be promising, showing feasibility of the technique in endometrial carcinoma. Detection of sentinel lymph nodes in endometrial cancer has recently been described by hysteroscopic injection of technetium-99 labeled colloids. The results of these studies seem to be promising, showing feasibility of the technique in endometrial carcinoma. InterventionIn our institute we performed hysteroscopic injection of technetium-99 labeled colloids using the 4 mm Bettocchi hysteroscope and a 5F diameter needle designed for this purpose. Three patients with an endometrial carcinoma diagnosed during office hysteroscopy were enrolled, after obtaining written consent, to participate in this preliminary study. The hysteroscopic injections were performed around the lesions, under the endometrium. Lymphoscintigraphic scans were performed after the injection of tracers. Twelve hours later, following total hysterectomy with bilateral salpyngo-oophorectomy, it was possible by means of radio-guided surgery to remove marked lymph nodes. In our institute we performed hysteroscopic injection of technetium-99 labeled colloids using the 4 mm Bettocchi hysteroscope and a 5F diameter needle designed for this purpose. Three patients with an endometrial carcinoma diagnosed during office hysteroscopy were enrolled, after obtaining written consent, to participate in this preliminary study. The hysteroscopic injections were performed around the lesions, under the endometrium. Lymphoscintigraphic scans were performed after the injection of tracers. Twelve hours later, following total hysterectomy with bilateral salpyngo-oophorectomy, it was possible by means of radio-guided surgery to remove marked lymph nodes. Measurements and Main ResultsAll three hysteroscopic procedures were performed with the vaginoscopic approach and without patient discomfort. Injection of the tracers with the appropriate needle was easy to perform between the endometrium and the myometrium. Minimal pain was suffered by the patients when the needle touched the myometrium. Radio-guided surgery detected, in the first patient, three sentinel lymph nodes, in the second patient two lymph nodes and in the third patient four lymph nodes. All the lymph nodes resulted negative at the pathologic control. All three hysteroscopic procedures were performed with the vaginoscopic approach and without patient discomfort. Injection of the tracers with the appropriate needle was easy to perform between the endometrium and the myometrium. Minimal pain was suffered by the patients when the needle touched the myometrium. Radio-guided surgery detected, in the first patient, three sentinel lymph nodes, in the second patient two lymph nodes and in the third patient four lymph nodes. All the lymph nodes resulted negative at the pathologic control. ConclusionThe sentinel lymph node technique has proven to be feasible in endometrial adenocarcinoma. Controlled studies are necessary to verify the true indications for the technique in this kind of cancer. The sentinel lymph node technique has proven to be feasible in endometrial adenocarcinoma. Controlled studies are necessary to verify the true indications for the technique in this kind of cancer.