Sentinel Lymph Node Mapping in Gynecologic Cancers

Abstract

Sentinel lymph node (SLN) mapping has emerged as a promising alternative to comprehensive surgical staging of endometrial, cervical, and vulvar cancers. For cervical and endometrial cancer, cervical injection of indocyanin green dye and/or radiocolloid has resulted in high rates of bilateral SLN identification. Although feasible and safe, prospective trials have not yet clearly determined the false negative rate of SLN mapping for cervical and endometrial cancers. For this reason, SLN mapping has not yet achieved widespread acceptance. In vulvar cancer, prospective trials have demonstrated the safety of SLN mapping and, in many centers, have led to the substitution of SLN mapping for completion lymphadenectomy without compromising long-term outcomes. Further study will hopefully determine whether SLN mapping can replace lymphadenectomy in a greater proportion of patients with gynecologic cancers.