Laparoscopically-Assisted Sentinel Lymph Node Detection Using Blue-Dye in Endometrial Cancer

Holub, Z; Jabor, Antonı́n; Kliment, L; Urbánek, Š

doi:10.1136/ijgc-00009577-200303001-00240

Cited by 20 publications

(30 citation statements)

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“…The depth of the injection should be 2-5 mm (the level of the sub-epithelial network). The observation reported by Dargent et al [39] in patients with cervical cancer has bee confirmed by others in cases of [40]: successful SND detection depends on both the sites of injection and the volume of BPD. Albumin and synthetic colloidal particles are used as radiocolloids.…”

Section: Targeting the Nodessupporting

confidence: 60%

Laparoscopic management of early endometrial cancer: current status

Holub

2006

Gynecol Surg

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Endometrial cancer is the most common form of gynaecological cancer. Laparotomy has traditionally been the surgical treatment of choice, but the laparoscopic approach is gaining wider acceptance by gynaecologic surgeons, and an abundance of clinical information is currently available on all aspects of this approach. Whether in combination with laparoscopic-assisted vaginal or total laparoscopic hysterectomy, laparoscopic staging, including salpingo-oophorectomy and regional lymph-node dissection, is a major component of the treatment of patients with early endometrial cancer. This review examines the various options to treating endometrial cancer and proposes that laparoscopically assisted surgical staging of endometrial cancer is both a feasible and safe option. Comparative analyses of survival and recurrence rates for patients treated by laparoscopy and laparotomy have shown similar survival results. It remains to be proven if these laparoscopic techniques are associated with greater benefits.

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Section: Targeting the Nodessupporting

confidence: 60%

Laparoscopic management of early endometrial cancer: current status

Holub

2006

Gynecol Surg

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“…There were miscellaneous injection methods of the tracers in previous reports. The intra-operative subserous injection was one of the most direct and convenient ways, and the course of dye drainage was in full agreement with that of the lymphatic metastasis in tumor infi ltration of the deep myometrium [4,7,9,10] . In our study, this method has been utilized and improved.…”

Section: Discussionmentioning

confidence: 71%

“…However, this provides an ideal model for the SLN procedure, enabling the SLN identifi cation in EC with clinical signifi cance. This kind of study is now at its primary stage, which is quite different in technique compared to several other studies [4][5][6][7][8][9][10][11] . As for choice of the tracer, the methylene blue dye was chosen as the tracer in our study, which is not only because its safety is superior to other dyes such as isosulfan blue etc.…”

Section: Discussionmentioning

confidence: 94%

Sentinel lymph node identification in endometrial cancer

et al. 2009

Clin. Oncol. Cancer Res.

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OBJECTIVETo evaluate the feasibility of intra-operative detection of sentinel lymph nodes (SLN) in the patient with endometrial cancer (EC). METHODS Thirty-one patients with Stage I and II endometrial cancer, who underwent a hysterectomy and a lymphadenectomy, were enrolled in the study. At laparotomy, methylene blue dye tracer was injected into the subserosal myometrium of corpus uteri at multiple sites, and dye uptake into the lymphatic channels was observed. The blue nodes which were identifi ed as SLNs were traced and excised. The other nodes were then removed. All of the excised nodes were submitted for pathological hematoxylin and eosin (H&E) staining examination. RESULTS Failure of dye uptake occurred in 4 of the 31 cases (12.9%) because of spillage, and no lymphatic coloration was observed there. Lymphatic staining was clearly observable as blue dye diff used to the lymphatic channels of the uterine surface and the infundibulopelvic ligaments in 27 (87.1%) cases. Concurrent coloration in the pelvic lymphatic vessels was also observed in 22 of the 27 patients. The SLNs were identifi ed in 23 of the 27 (85.2%) cases with a lymphatic staining, with a total number of 90 SLNs, and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%) in the para-aortic area, the other 89 (98.9%) were in the nodes of the pelvis. The most dense locations of SLNs included obturator in 38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelvic lymphadenectomy was conducted in 27 (87.1%) patients and pelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrent abdominal para-aortic lymph node sampling was conducted in 7. A total of 926 nodes were harvested, with an average of 39.8 in each case (range, 14-55). Nodal metastases occurred in 3 patients (9.7%), 2 of them with SLN involvement and the other without SLN involvement. Adverse reactions or injury related to the study was not found. CONCLUSION Application of methylene blue dye is feasible in an intra-operative SLN identification of endometrial cancer. The technology is convenient, safe, and worth further investigation.KEY WORDS: endometrial tumor, lymphatic metastasis, sentinel lymph node biopsy, lymphadenectomy.

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“…There are further potential indications for performing a laparoscopy in endometrial cancer. For instance, some researchers are working on the development of sentinel lymph node detection in this malignancy [54]. Others recommend a staging laparoscopy like that for advanced cervical cancer [55] in order to exclude intraabdominal manifestations in very early endometrial cancer if a uteruspreserving procedure is planned in women who wish to preserve their fertility [56].…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Based on the systematic investigations by the groups of Hatch and Childers et al [13,20,25], Eltabbakh et al [8,23,36,49], Holub et al [9,14,38,48,54], Magrina et al [47,50], and Schneider et al [18,41,46,51,57,58] surgical measures are recommended as described below. In general, outside clinical studies LAVH ± LAE should be restricted to cases deemed FIGO stage I [3].…”

Section: Surgical Managementmentioning

confidence: 99%

Laparoscopic-assisted vaginal hysterectomy with laparoscopic pelvic and paraaortic staging for early endometrial cancer

Ulrich

Rhiem

Janschek³

et al. 2006

Gynecol Surg

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While abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic and paraaortic lymphadenectomy is still considered the gold standard for the surgical treatment of endometrial cancer, the laparoscopicassisted vaginal hysterectomy (LAVH) plus laparoscopic lymphadenectomy has been performed in FIGO stage I endometrial cancer in selected centers for about a decade. Clinical studies have shown that the frequency of intra-and postoperative complications, the pelvic and paraaortic lymph node yield, and-more importantly-the overall survival, are similar both with the laparoscopic-assisted vaginal approach and the abdominal approach in stage I disease. Blood loss and duration of hospital stay may even be reduced with the LAVH. In summary, provided there is compliance with established oncologic guidelines, LAVH with pelvic and paraaortic lymphadenectomy can probably be performed in patients with endometrial cancer FIGO stage I without safety loss.

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Laparoscopically-Assisted Sentinel Lymph Node Detection Using Blue-Dye in Endometrial Cancer

Cited by 20 publications

References 0 publications

Laparoscopic management of early endometrial cancer: current status

Laparoscopic management of early endometrial cancer: current status

Sentinel lymph node identification in endometrial cancer

Laparoscopic-assisted vaginal hysterectomy with laparoscopic pelvic and paraaortic staging for early endometrial cancer

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