A feasibility study of sentinel lymph node mapping by cervical injection of a tracer in Japanese women with early stage endometrial cancer

Taiwan J Obstet Gynecol. 2018 Aug;57(4):541-545. doi: 10.1016/j.tjog.2018.06.012.

Abstract

Objective: The aim of this study was to investigate the feasibility of sentinel lymph node mapping characterized by a cervical tracer injection in endometrial cancer.

Materials and methods: This retrospective study was carried out using data for 57 patients with endometrial carcinoma who had undergone intraoperative sentinel lymph node mapping and subsequent surgical staging. Technetium colloid and/or indocyanine green was injected into the uterine cervix and a gamma-detecting probe and/or photodynamic eye camera system was used intraoperatively to locate hot spots.

Results: Of the 57 patients, 52 (91.2%) had FIGO Stage I disease. Successful unilateral or bilateral mapping occurred in 54 patients (94.7%) and 46 (80.7%), respectively. The median number of sentinel lymph nodes detected was two (range, 0-5). Following sentinel lymph node mapping, 41 patients (71.9%) underwent pelvic lymphadenectomy alone and 16 (28.1%) full lymphadenectomy. The median number of lymph nodes resected was 17 (range, 8-110). Sentinel lymph nodes were involved in four patients (7.0%), two with macrometastases and two with low-volume metastases. The sensitivity and negative predictive value for detecting lymph node metastasis were both 100%.

Conclusion: Sentinel lymph node mapping with the use of cervical tracer injection is highly feasible in Japanese women with early stage endometrial cancer.

Keywords: Cervical injection; Endometrial cancer; Sensitivity; Sentinel lymph node; Uterine cancer.

MeSH terms

  • Adult
  • Aged
  • Cervix Uteri / drug effects
  • Colloids
  • Endometrial Neoplasms / diagnostic imaging
  • Endometrial Neoplasms / pathology*
  • Feasibility Studies
  • Female
  • Humans
  • Indocyanine Green / administration & dosage*
  • Japan
  • Lymph Node Excision / statistics & numerical data
  • Lymphatic Metastasis / diagnosis
  • Middle Aged
  • Phytic Acid
  • Radionuclide Imaging / methods
  • Retrospective Studies
  • Sentinel Lymph Node / diagnostic imaging*
  • Sentinel Lymph Node / pathology*
  • Sentinel Lymph Node / surgery
  • Technetium / administration & dosage*
  • Technetium Compounds / administration & dosage

Substances

  • Colloids
  • Technetium Compounds
  • Technetium
  • Phytic Acid
  • Indocyanine Green