Skip Navigation LinksHome > September 2013 - Volume 23 - Issue 7 > Evaluation of the Sentinel Lymph Node Algorithm With Blue Dy...
International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0b013e31829b1b98
Uterine Cancer

Evaluation of the Sentinel Lymph Node Algorithm With Blue Dye Labeling for Early-Stage Endometrial Cancer in a Multicentric Setting

Vidal, Fabien MD; Leguevaque, Pierre MD, PhD*; Motton, Stephanie MD*; Delotte, Jerome MD; Ferron, Gwenael MD; Querleu, Denis MD, PhD; Rafii, Arash PhD§

Collapse Box

Abstract

Objectives: Sentinel lymph node (SLN) removal may be a midterm between no and full pelvic dissection in early endometrial cancer. Whereas the use of blue dye alone in SLN detection has a poor accuracy, its integration in an SLN algorithm may yield better results and overcome hurdles such as the requirement of nuclear medicine facility.

Methods: Sixty-six patients with clinical stage I endometrial cancer were prospectively enrolled in a multicentre study between May 2003 and June 2009. Patent blue was injected intraoperatively into the cervix. We retrospectively assessed the accuracy of a previously described SLN algorithm consisting of the following sequence: (1) pelvic node area is inspected for removal of all mapped SLN and (2) excision of every suspicious non-SLN, (3) in the absence of mapping in a hemipelvis, a standard ipsilateral lymphadenectomy is then performed.

Results: Sentinel nodes were identified in 41 patients (62.1%), mostly in interiliac and obturator areas. None was detected in the para-aortic area. Detection was bilateral in 23 cases (56.1%). Seven patients (10.6%) had positive nodes. The false-negative rate was 40% using SLN detection alone. When the algorithm was applied, the false-negative rate was 14.3%. The use of a SLN algorithm would have avoided 53% of lymphadenectomies

Conclusion: Our multicentric evaluation validates the use of a SLN algorithm based on blue-only sentinel node mapping in early-stage endometrial cancer. The application of such SLN algorithm should be evaluated in a prospective context and might lead to decrease unnecessary lymphadenectomies.

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.

Login

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us

Twitter
twitter.com/IJGConline

For additional oncology content, visit LWW Oncology Journals on Facebook.