The role of sentinel-node biopsy in ovarian cancer

Minerva Ginecol. 2020 Dec;72(6):399-403. doi: 10.23736/S0026-4784.20.04691-2. Epub 2020 Nov 3.

Abstract

Lymph node involvement is an important prognostic factor in early and advanced epithelial ovarian cancer (EOC). However, to date there is no reliable method of detecting lymph node involvement, apart from surgical staging. Thus, pelvic and paraaortic lymphadenectomy (LNE) are still part of standard surgery of early ovarian cancer. There is conflicting evidence about the therapeutic value of systematic LNE in early EOC. Thus, the developmemt of a method to predict nodal status accurately, without extensive LNE, is the subject of ongoing research. Sentinel lymphadenectomy (SLN) has become a standard procedure in oncological surgery. However, SLN is not yet an established and widely accepted procedure for EOC. This review aimed at summarizing available evidence on its feasibility and reliability in EOC. Overall, evidence of SLN in early EOC is still scarce. So far, only small series of patients with a variety of tracers and injection sites were published. From the available literature, the most promising technique seems to be injection into the infundibulopelvic, as well as the proper ovarian ligament. Indocyanine green seems to be an excellent tracer for successful SLN of ovarian tumors, which can be used during laparoscopic or robotic surgery. The detection rates and true positive rates of studies support further investigation of the technique. Results from prospective studies, e.g. the ongoing SELLY trial, are necesssary to implement SLN into the standard treatment of early EOC.

Publication types

  • Review

MeSH terms

  • Carcinoma, Ovarian Epithelial / diagnostic imaging
  • Carcinoma, Ovarian Epithelial / pathology*
  • Carcinoma, Ovarian Epithelial / surgery
  • Coloring Agents / administration & dosage
  • Female
  • Humans
  • Indocyanine Green / administration & dosage
  • Injections / methods
  • Lymph Node Excision / methods
  • Ovarian Neoplasms / diagnostic imaging
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Radiopharmaceuticals / administration & dosage
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sentinel Lymph Node / diagnostic imaging
  • Sentinel Lymph Node / pathology*
  • Sentinel Lymph Node Biopsy / methods*
  • Technetium / administration & dosage

Substances

  • Coloring Agents
  • Radiopharmaceuticals
  • Technetium
  • Indocyanine Green