Detection and feasibility of the SLN concept in the management of endometrial cancer. Literature review

Abstract

Determining the lymph node status in endometrial cancer (EC) is essential for staging, prognosis and establishing the adjuvant therapy and is considered the most significant independent prognostic factor of recurrence. As the current imaging methods are not sufficient to stage EC patients, complete pelvic and para-aortic lymphadenectomies are being considered standard staging procedures. The introduction of the sentinel lymph node (SLN) concept in the management of EC can provide better staging information and is considered to be a valuable alternative to complete lymphadenectomy with a significant lower morbidity rates. The aim is to make a review of the current literature on the method of detection, and feasibility of the SLN concept in women with EC. A literature review was performed by searching for English articles in PubMed and Medline databases without date limitations. The keywords were: “endometrial cancer”, “sentinel lymph node”, “dissection”, “lymphadenectomy”. The use of the SLN biopsy can accurately stage intermediate-and high-risk women with stage 1EC, hence reducing unnecessary complete lymphadenectomies. Although SLN dissection continues to have encouraging results, because of the complex lymphatic drainage pattern of EC, many other issues need further clarification in order to implement the SLN concept in the standard management of early-stage EC.