Barranger Emmanuel, Delpech Yann, Coutant Charles, Dubernard Gil, Uzan Serge, Darai Emile
Department of Gynecologic and Breast cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de Chine, 75020 Paris, France.
Am J Surg. 2009 Jan;197(1):1-7. doi: 10.1016/j.amjsurg.2007.10.021. Epub 2008 Jun 16.
To evaluate the feasibility of a laparoscopic sentinel node (SN) procedure based on combined method in patients with endometrial cancer.
Thirty-three patients (median age 66.1 years) with endometrial cancer of apparent stage I or stage II underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically. After the SN procedure, all the patients underwent laparoscopic bilateral pelvic lymphadenectomy.
SNs were identified in only 27 patients (81.8%). The mean number of SNs was 2.5 per patient (range 1-5). Only 18 patients (54.5%) had an identified bilateral SN. The most common site of the SNs was the medial external iliac region (67.6%). Fourteen SNs (19.7%) from 8 patients (24.2%) were found to be metastatic at the final histological assessment. No false-negative SN results were observed.
A SN procedure based on a combined detection and laparoscopic approach is feasible in patients with early endometrial cancer. However, because of a low rate of bilateral and global SN detections and problems of injection site using pericervical injection of radiocolloid and blue dye, alternative methods should be explored. Pericervical injections should be avoided.
