A pilot study of sentinel lymph nodes identification in patients with endometrial cancer

Abstract

16022 Background: The sentinel lymph node (SLN) biopsy has showed the feasibility to limit the extent of lymphadenectomy in vulvar and cervical cancer, but few studies have examined this procedure in endometrial cancer. The aim of this study is to examine the feasibility of SLN identification for the patients with endometrial cancer. Methods: Twenty patients with endometrial cancer undergoing hysterectomy and lymphadenectomy were included in the study. At laparotomy, methylene blue dye was injected into the subserosal myometrium of corpus uteri at multiple sites. Dye uptake into lymphatic channels was observed and blue nodes were identified as SLNs. The SLNs were biopsied before lymphadenectomy performed. The samples of SLNs and non-SLNs were recorded separately and correlated with the final pathological results. Results: Dye uptake into lymphatic channels was seen in all 20 cases. Among them, SLN was identified in 15 (75%) cases. A total of 71 SLNs with a mean number of 4.7 (range, 1–10) were identified from all pelvic sites. The most frequent locations of SLNs included obturator in 29 (41%), interiliac in 16 (26%). No dye-containing paraaortic node was found. Two patients (10%) had nodal metastases, and they all had at least one SLN found to be positive, the false-negative-rate was 0. No adverse reactions or injures were attributed to the study. Conclusions: This study shows the feasibility and safety of SLN identification with blue dye in patients with endometrial cancer undergoing staging surgery. The SLNs accuratly predicted the nodal metastases in the study.This approach might provide an alternative to limit the extent of nodal sampling. No significant financial relationships to disclose.