Robotic-Assisted Sentinel Lymph Node Sampling in Endometrial Cancer

Curcio, Erin; Giglio, A.; Dewan, Anil; ElSahwi, Karim

doi:10.1016/j.jmig.2018.09.164

Cited by 3 publications

(3 citation statements)

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“…SLN evaluation has become a widely adopted technique for endometrial cancer staging due to its safety and high sensitivity in detecting lymph node metastasis when combined with ultra-staging using immunohistochemistry [20,21,28,29], and an NCCN algorithm is a sanctioned standard of care in its management [22,24]. SLN Mapping using cervical injection of ICG dye under near infrared light has shown an improved sensitivity and negative predictive value [16; 20-21], and although the technology is available in different platforms, it is safe to assume that most gynecological oncologists in the United States are currently well trained to perform the procedure expeditiously and safely using the da Vinci (Intuitive Surgical, Sunnyvale CA) robotic platform [7,20,30,31].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Sentinel Lymph Nodes in Complex Atypical Endometrial Hyperplasia

Al Kallas,

Cooper,

Varma

et al. 2024

Preprint

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Complex atypical endometrial hyperplasia (CAH) carries a high probability of cancer. Intraoperative evaluation of endometrial cancer in cases of CAH has not been reliable. The safety and sensitivity of sentinel lymph node (SLN) sampling has been validated. We aim to evaluate the efficacy and safety of SLN sampling in CAH managed by the da Vinci robotic platform. A total of 113 patients with a preoperative diagnosis of CAH were included in this retrospective cohort study. All underwent a robot assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with 69 patients undergoing SLN sampling. Statistical analysis calculated the probability of cancer, SLN map rate, and surgical complications. Predictors of cancer were evaluated. Forty-seven percent of the entire cohort were diagnosed with endometrial cancer. Median age was 63 years in the SLN cohort (N = 69) and 61 in the No SLN cohort (N = 44) (p= 0.363). Median BMI was 34 Kg/m2 in the SLN cohort and 40 in the No SLN cohort (p= 0.004). Bilateral SLN map was 92.8% and unilateral SLN map rate was 7.2%. There were no grade 3-4 complications in the SLN cohort, and 4 grade 3-4 complications in the No SLN group (p=0.021). A preoperative diagnosis of CAH bordering on or cannot rule out cancer was the only predictor of cancer.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Sentinel Lymph Nodes in Complex Atypical Endometrial Hyperplasia

Al Kallas,

Cooper,

Varma

et al. 2024

Preprint

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“…SLN evaluation has become a widely adopted technique for endometrial cancer staging due to its safety and high sensitivity in detecting lymph node metastasis when combined with ultra-staging using immunohistochemistry [20,21,26,27], and an NCCN algorithm is a sanctioned standard of care in its management [22,28]. SLN mapping using a cervical injection of ICG dye under near-infrared light has shown an improved sensitivity and a negative predictive value [16,20,21], and, although the technology is available in different platforms, it is safe to assume that most gynecological oncologists in the United States are currently well trained to perform the procedure expeditiously and safely using the da Vinci (Intuitive Surgical, Sunnyvale CA) robotic platform [7,20,29,30].…”

Section: Discussionmentioning

confidence: 99%

“…SD: standard deviation; SLN: sentinel lymph node; LOS: length of surgery; EBL: estimated blood loss; $ Clavien-Dindo classification system of complications[26,27]; and mL: milliliters. Student's t-test performed to analyze the mean LOS and EBL.…”

mentioning

confidence: 99%

Evaluation of Sentinel Lymph Nodes in Complex Atypical Endometrial Hyperplasia

Al Kallas,

Cooper,

Varma

et al. 2024

Lymphatics

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Complex atypical endometrial hyperplasia (CAH) carries a high probability of cancer. The intraoperative evaluation of endometrial cancer in cases of CAH has not been reliable. The safety and sensitivity of sentinel lymph node (SLN) sampling has been validated. In our study, we aimed to evaluate the efficacy and safety of SLN sampling in CAH managed by the da Vinci robotic platform. A total of 113 patients with a preoperative diagnosis of CAH were included in this retrospective cohort study. All of them underwent a robot-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy, with 69 patients undergoing SLN sampling. A statistical analysis calculated the probability of cancer, the SLN map rate, and surgical complications. The predictors of cancer were evaluated. Descriptive statistics were used to summarize the results; comparative statistics were used to compare the cohorts; and logistical regression analysis was used to predict the risk. Forty-seven percent of the entire cohort was diagnosed with endometrial cancer. The median age was 63 years in the SLN cohort (N = 69) and 61 in the No-SLN cohort (N = 44) (p = 0.363). The median BMI was 34 Kg/m2 in the SLN cohort and 40 in the No-SLN cohort (p = 0.004). The bilateral SLN map was 92.8%, and the unilateral SLN map rate was 7.2%. There were no grade-3–4 complications in the SLN cohort, and four grade-3–4 complications in the No-SLN group (p = 0.021). A preoperative diagnosis of CAH bordering on or unable to rule out cancer was the only predictor of cancer. Sentinel lymph node sampling has a high map rate and low complications in CAH. We recommend a prospective study investigating the clinical benefit of the procedure.

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