Controversy over sentinel lymph node detection in endometrial cancer

Paredes, Pilar; Díaz-Feijoó, Berta; Galán, E.V. Aguilar; Martínez, M. de Matías; Cabero, S. Fuertes

doi:10.1016/j.remnie.2022.09.012

Cited by 1 publication

(4 citation statements)

References 47 publications

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“…Several studies supported the feasibility of implementing sentinel node mapping in apparent early-stage endometrial cancer [ 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 38 39 40 41 42 43 44 45 ]. However, it is important to point out that the quality of evidence is still scant, since no data from a phase III randomized trial are available.…”

Section: Discussionmentioning

confidence: 99%

“…However, a meta-regression on various studies showed that sensitivities are similar between various tracers and combination of tracers [ 35 ]. Another topic deserving attention is the most appropriate site of tracers’ injection [ 18 33 42 43 ]. Cervical injection (at 3 and 9 o’clock) is the most used injection site because of the high reproducibility of the procedure.…”

Section: Body Of Evidencementioning

confidence: 99%

“…Cervical injection (at 3 and 9 o’clock) is the most used injection site because of the high reproducibility of the procedure. Other popular injection technique included the execution of fundal and hysteroscopic injections [ 18 42 43 ]. Fundal injection failed to demonstrated a benefit in sentinel node mapping identification.…”

Section: Body Of Evidencementioning

confidence: 99%

“…Fundal injection failed to demonstrated a benefit in sentinel node mapping identification. The main reasons is that this type of technique is skipping the drainage within the parametria and more importantly the majority of endometrial tumors are not invading the serosal [ 43 ]. Following a logical assumption peri-tumoral injection, via hysteroscopy, would provide a more accurate detection of the real nodes draining the tumor.…”

Section: Body Of Evidencementioning

confidence: 99%

See 3 more Smart Citations

Sentinel node mapping in endometrial cancer

Bogani,

Giannini,

Vizza

et al. 2024

J Gynecol Oncol

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Nodal status is one of the most important prognostic factors for patients with apparent early stage endometrial cancer. The role of retroperitoneal staging in endometrial cancer is controversial. Nodal status provides useful prognostic data, and allows to tailor the need of postoperative treatments. However, two independent randomized trials showed that the execution of (pelvic) lymphadenectomy increases the risk of having surgery-related complication without improving patients’ outcomes. Sentinel node mapping aims to achieve data regarding nodal status without increasing morbidity. Sentinel node mapping is the removal of first (clinically negative) lymph nodes draining the uterus. Several studies suggested that sentinel node mapping is not inferior to lymphadenectomy in identifying patients with nodal disease. More importantly, thorough ultrastaging sentinel node mapping allows the detection of low volume disease (micrometastases and isolated tumor cells), that are not always detectable via conventional pathological examination. Therefore, the adoption of sentinel node mapping guarantees a higher identification of patients with nodal disease than lymphadenectomy. Further evidence is needed to assess the value of various adjuvant strategies in patients with low volume disease and to tailor those treatments also on the basis of the molecular and genomic characterization of endometrial tumors.

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