| Abstract: |
Sentinel lymph node (SLN) mapping in early-stage endometrial cancer has been used for nearly two decades, but has only been gaining acceptance over the past 5 years. In 2014, the National Comprehensive Cancer Network (NCCN) guidelines began including SLN mapping and the Memorial Sloan Kettering SLN algorithm as an option for the surgical staging of select women with endometrial cancer. SLN mapping is a form of image-guided surgery that can enhance a surgeon’s ability to find the SLN, or the purported first node involved in lymphatic metastases from the primary cancer. The SLN concept is rooted in the idea that lymph node metastasis occurs sequentially; therefore, if the SLN is negative for metastasis, then the ensuing nodes should also be negative. Following a cervical injection of colored dye, SLNs are three times more likely to harbor disease than non-SLNs; and with immunohistochemical “ultrastaging,” pathologists were able to detect an additional 3-8 % of micrometastasis to SLNs, which may have been otherwise missed by routine H & E. Overall, the use of SLN mapping in early-stage endometrial cancer can help select patients avoid an extensive lymphadenectomy, which is associated with long-term side effects, including lower extremity lymphedema. In this chapter, we will discuss SLN mapping techniques and address the reported outcomes of various studies. © Springer-Verlag London 2015. |
