Sentinel lymph node in endometrial cancer: an overview

Gonçalves, Elisabete; Figueiredo, Odete; Costa, Fernanda Marques da

doi:10.1007/s10397-013-0796-2

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…On the other hand, the uterine corpus drains not only to the external iliac but also to interiliac, common iliac, and obturator nodes as well. Uterine fundal drainage occurs consistently through the ovarian lymphatic channels to the infra-renal and para-aortic regions [ 36 ]. The findings in this study are based on a small series and warrant further evaluation in the context of a larger prospective cohort.…”

Section: Discussionmentioning

confidence: 99%

The uterine pathological features associated with sentinel lymph node metastasis in endometrial carcinomas

Kang¹,

Kim²,

Gjertson³

et al. 2020

PLoS ONE

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Background In recent years, sentinel lymph node excision and ultrastaging have been performed in endometrial carcinomas to obtain information about lymph node status, avoiding unnecessary complete pelvic and paraaortic lymphadenectomy. The purpose of this retrospective study was to provide a comprehensive evaluation of the pathological features of endometrial carcinomas and their significance in association with sentinel lymph node involvement. Methods Patients with endometrial carcinomas, preceded by sentinel lymph node mapping, were classified into Group-I and Group-II with negative and positive involvement, respectively. The pathological features, associated with sentinel lymph node involvement, were statistically analyzed, including determination of test performance parameters. Results Among 70 patients who had undergone hysterectomy and sentinel lymph node excision, 61 had carcinoma and 9 had atypical hyperplasia. There were 50 patients in Group-I and 10 in Group-II. In Group-II, the significant pathological features were: 1) lower uterine segment involvement (100%), 2) an average tumor size of ≥5 CM, 3) lymphovascular invasion (50%), 4) cervical stromal invasion (40%), and 5) depth of myometrial invasion of ≥50% (50%). The incidences of these pathological features were significantly less in Group-I. Statistical analyses singled out “lower uterine segment involvement” as the most important feature. Conclusions We have identified five pathological features which are associated with sentinel lymph node involvement. Since lower uterine segment involvement has occurred in all cases of the Group-II cohort, we recommend FIGO and other organizations that determine staging rules should consider whether tumors that involve the lower uterine segment should be staged as higher than “1a”, if the findings in this small series are confirmed by other studies. The results of this study may guide pathologists and oncologists in the diagnostic and therapeutic approaches to management of endometrial carcinomas.

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Section: Discussionmentioning

confidence: 99%

The uterine pathological features associated with sentinel lymph node metastasis in endometrial carcinomas

Kang¹,

Kim²,

Gjertson³

et al. 2020

PLoS ONE

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“…The lymphatic drainage of the lower uterine segment is the same as that of the cervix, which drains through the parametria to the iliac and obturator nodes at the pelvic sidewall, common iliac LNs, para-aortic LNs and beyond ( Figure 1 ). Alternative drainage near the uterine fundus develops along the gonadal vessels directly to the para-aortic nodes [ 14 , 15 ]. This implies that if the SLN is in the para-aortic region, it might be missed by the usual SLNB techniques that target the pelvic nodes (see Section 3 ).…”

Section: Lymphatic Drainage Of Endometrial Cancermentioning

confidence: 99%

Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer

Chiu

Kwok

Wang

et al. 2022

JCM

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Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality of life of the patients. The sentinel lymph node is the first lymph node that tumor cells drain to, and sentinel lymph node biopsy has emerged as an acceptable alternative to full lymphadenectomy in both low-risk and high-risk endometrial cancer. Evidence has demonstrated a high detection rate, sensitivity and negative predictive value of sentinel lymph node biopsy. It can also reduce surgical morbidity and improve the detection of lymph node metastases compared with systematic lymphadenectomy. This review summarizes the current techniques of sentinel lymph node mapping, the applications and oncological outcomes of sentinel lymph node biopsy in low-risk and high-risk endometrial cancer, and the management of isolated tumor cells in sentinel lymph nodes. We also illustrate a revised sentinel lymph node biopsy algorithm and advocate to repeat the tracer injection and explore the presacral and paraaortic areas if sentinel lymph nodes are not found in the hemipelvis.

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“…The uterine corpus drains primarily to the external iliac nodes; other pathways include the inter iliac, common iliac, and obturator area. Uterine fundal drainage is relatively consistent through the ovarian vessels to the infra-renal paraaortic area [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Near-Infrared Technologies to Detect Sentinel Lymph Node in Uterine Cancer: A Prospective Comparative Cohort Study

Restaino

Bizzarri

Tarantino

et al. 2022

IJERPH

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Objectives: Sentinel lymph node biopsy is considered a crucial step in endometrial cancer staging. Cervical injection has become the most favored technique and indocyanine green has been demonstrated to be more accurate than other tracers. Different near-infrared camera systems are currently being used to detect indocyanine green in sentinel lymph nodes and have been compared in different patients. The present study aimed to determine the number and site of sentinel lymph nodes detected in the same patients with two different near-infrared technologies. Methods: This is a prospective, single-center, observational, non-sponsored study. Patients with presumed uterine-confined endometrial cancer were prospectively enrolled. After cervical injection, two different near-infrared cameras were used to detect sentinel lymph nodes at the same time: Olympus, Tokyo, Japan—considered the standard (SNIR); and Medtronic, Minneapolis, MN, USA with VISION SENSE® which is a new laser near-infrared (LNIR) fluorescence laparoscope. The two cameras were alternatively switched on to detect sentinel lymph nodes in the same patients. Results: Seventy-four consecutive patients were included in the study. Most of the patients were diagnosed with endometrioid histology (62, 83.8%), FIGO stage IA (48, 64.9%), grade 2 (43, 58.1%), and underwent surgery with laparoscopic approach (70, 94.0%). The bilateral detection rate was 56/74 (75.7%) with SNIR and 63/74 (85.1%) with LNIR (p = 0.214). The total number of sentinel lymph nodes identified in the left hemipelvis was 65 and 70 with SNIR and LNIR, respectively; while in the right hemipelvis, there were 74 and 76, respectively. The median number of sentinel lymph nodes identified with SNIR and LNIR was 2 (range, 0–4) and 2 (range, 0–4), respectively (p = 0.370). No difference in site of sentinel lymph node detection was evident between the two technologies (p = 0.994). Twelve patients (16.2%) had sentinel lymph node metastasis: in all cases metastatic sentinel lymph nodes were detected both with Olympus and LNIR. Conclusions: No difference in bilateral detection rate and number or site of sentinel lymph node detection was evident comparing two different technologies of near-infrared camera for ICG detection in endometrial cancer patients. No difference in sentinel lymph node metastases identification was detected between the two technologies.

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Sentinel lymph node in endometrial cancer: an overview

Cited by 4 publications

References 35 publications

The uterine pathological features associated with sentinel lymph node metastasis in endometrial carcinomas

The uterine pathological features associated with sentinel lymph node metastasis in endometrial carcinomas

Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer

Comparison of Different Near-Infrared Technologies to Detect Sentinel Lymph Node in Uterine Cancer: A Prospective Comparative Cohort Study

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