The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: Beyond removal of blue nodes Journal Article
| Authors: | Barlin, J. N.; Khoury-Collado, F.; Kim, C. H.; Leitao, M. M.; Chi, D. S.; Sonoda, Y.; Alektiar, K.; DeLair, D. F.; Barakat, R. R.; Abu-Rustum, N. R. |
| Article Title: | The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: Beyond removal of blue nodes |
| Abstract: | Objective: To determine the false-negative rate of a surgical sentinel lymph node (SLN) mapping algorithm that incorporates more than just removing SLNs in detecting metastatic endometrial cancer. Methods: A prospective database of all patients who underwent lymphatic mapping for endometrial cancer was reviewed. Cervical injection of blue dye was used in all cases. The surgical algorithm is as follows: 1) peritoneal and serosal evaluation and washings; 2) retroperitoneal evaluation including excision of all mapped SLNs and suspicious nodes regardless of mapping; and 3) if there is no mapping on a hemi-pelvis, a side-specific pelvic, common iliac, and interiliac lymph node dissection (LND) is performed. Paraaortic LND is performed at the attendings' discretion. The algorithm was retrospectively applied. Results: From 9/2005 to 4/2011, 498 patients received a blue dye cervical injection for SLN mapping. At least one LN was removed in 95% of cases (474/498); at least one SLN was identified in 81% (401/498). SLN correctly diagnosed 40/47 patients with nodal metastases who had at least one SLN mapped, resulting in a 15% false-negative rate. After applying the algorithm, the false-negative rate dropped to 2%. Only one patient, whose LN spread would not have been caught by the algorithm, had an isolated positive right paraaortic LN with a negative ipsilateral SLN and pelvic LND. Conclusions: Satisfactory SLN mapping in endometrial cancer requires adherence to a surgical SLN algorithm and goes beyond just the removal of blue SLNs. Removal of any suspicious node along with side-specific lymphadenectomy for failed mapping are an integral part of this algorithm. Further validation of the false-negative rate of this algorithm is necessary. © 2012 Elsevier Inc. All rights reserved. |
| Keywords: | adult; aged; major clinical study; conference paper; cancer staging; endometrial cancer; lymph node dissection; paraaortic lymph node; pelvis lymph node; sentinel lymph node mapping; endometrium cancer; sensitivity and specificity; sentinel lymph node; metastasis; false negative result; algorithm; surgery; predictive value; classification algorithm; sentinel lymph node mapping algorithm; sentinel lymph node metastasis |
| Journal Title: | Gynecologic Oncology |
| Volume: | 125 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2012-06-01 |
| Start Page: | 531 |
| End Page: | 535 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2012.02.021 |
| PROVIDER: | scopus |
| PUBMED: | 22366409 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 June 2012" - "CODEN: GYNOA" - "Source: Scopus" |
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