Abstract
BackgroundThe examination of a sentinel lymph node (SLN), where lymph node metastasis first occurs, may be advocated as an alternative staging technique. The aim of this study was to evaluate the feasibility and detection rates of an SLN biopsy in patients with endometrial cancer.Study designTwo hundred and eleven patients with endometrial cancer underwent an SLN biopsy at hysterectomy using three kinds of tracers including 99m-technetium-labeled tin colloid (99mTc), indigo carmine and indocyanine green. Factors related to the side-specific detection rate, sensitivity and false negative rate were analyzed.ResultsThe detection rates of the SLN biopsy using 99mTc, indigo carmine and indocyanine green were 77.9, 17.0 and 73.4%, respectively. The detection rate was lower in elderly patients (≥60 years) (67.9 vs 89.2%, p < 0.01), patients with >50% myometrial invasion (68.3 vs 85.2%, p < 0.01), patients with high-grade tumors (69.5 vs 84.9%, p < 0.01) and patients who underwent laparotomy (71.2 vs 84.9%, p < 0.01). There were no significant differences in body mass index. The sensitivity was not significantly different in any factor. However, the false negative rate was higher in patients with > 50% myometrial invasion (11.5 vs 1.2%, p < 0.01), high-grade tumors (13.3 vs 0.8%, p < 0.01) and who underwent laparotomy (12.2 vs 0.4%, p < 0.01).ConclusionPatients who underwent laparoscopy with < 50% myometrial invasion and low-grade tumors not only have higher detection rates, but also have lower false negative rates. These patients may avoid systemic lymphadenectomy according to the status of the SLN biopsy.
Highlights
Pelvic lymph node dissection (PLND) remains an important surgical procedure for treating endometrial cancer
Patients with < 50% myometrial invasion and low-grade tumors had higher detection rates, and had lower false negative (FN) rates; these patients could avoid systematic lymphadenectomy according to the status of the sentinel lymph node (SLN) biopsy
We recommended that systematic PLND and paraaortic lymph node dissection (PAND) should be performed in patients with high-risk endometrial cancers, such as patients with > 50% myometrial invasion or high-grade tumors, as these patients had lower detection rates and higher FN rates
Summary
Pelvic lymph node dissection (PLND) remains an important surgical procedure for treating endometrial cancer This technique has resulted in a favorable prognosis [1,2,3,4,5,6], as well as correct staging [7,8,9], in patients with endometrial cancer. For patients with endometrial cancer, the extent of lymph node dissection is determined according to myometrial invasion and tumor grade on preoperative magnetic resonance imaging, preoperative biopsy and intraoperative frozen sections. The accuracy of these examinations is not sufficient for decision-making of PLND [14,15,16,17] For these reasons, a sentinel lymph node (SLN) biopsy has gained attention. The false negative rate was higher in patients with > 50% myometrial invasion
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call