Dell'Orto Federica, Laven Pim, Delle Marchette Martina, Lambrechts Sandrina, Kruitwagen Roy, Buda Alessandro
Department of Obstetrics and Gynecology, Azienda Ospedaliera San Gerardo, Monza, Italy.
Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Int J Gynecol Cancer. 2019 Sep;29(7):1209-1215. doi: 10.1136/ijgc-2019-000606.
Pelvic and para-aortic lymphadenectomy is routinely performed in early ovarian cancer to define the stage of the disease. However, it may be associated with increased blood loss, operative time, and length of hospitalization. The sentinel lymph node technique has been shown to be safe and feasible in vulvar, uterine, and cervical cancer. Data detailing feasibility and outcomes of sentinel lymph node mapping in ovarian cancer are scarce.To summarize the studies evaluating the feasibility of sentinel lymph node detection from the ovary, examining the technique and detection rate.A systematic search of the literature was performed using PubMed and Embase from June 1991 to February 2019. Studies describing the sentinel lymph node technique and lymphatic drainage of the ovaries were incorporated in this review. Ten articles were selected, comprising a total of 145 patients. A variety of agents were used, but the primary markers were technetium-99m radiocolloid (Tc-99m), patent blue, or indocyanine green, and the most common injection site was the ovarian ligaments.The overall sentinel lymph node detection rate was 90.3%.We propose a standardized technique sentinel lymph node mapping in ovarian cancer, using indocyanine green, or Tc-99m and blue dye as alternative tracers, injected in both the suspensory and the infundibulopelvic ligament of the ovary.
盆腔和腹主动脉旁淋巴结切除术在早期卵巢癌中常规进行，以明确疾病分期。然而，它可能会导致失血量增加、手术时间延长和住院时间延长。前哨淋巴结技术已被证明在外阴癌、子宫癌和宫颈癌中是安全可行的。关于卵巢癌前哨淋巴结定位的可行性和结果的详细数据很少。为了总结评估从卵巢检测前哨淋巴结可行性的研究，研究该技术和检测率。我们使用PubMed和Embase对1991年6月至2019年2月的文献进行了系统检索。描述前哨淋巴结技术和卵巢淋巴引流的研究纳入了本综述。共选择了10篇文章，包括145例患者。使用了多种试剂，但主要标记物是锝-99m放射性胶体（Tc-99m）、专利蓝或吲哚菁绿，最常见的注射部位是卵巢韧带。前哨淋巴结的总体检测率为90.3%。我们提出一种标准化的卵巢癌前哨淋巴结定位技术，使用吲哚菁绿，或Tc-99m和蓝色染料作为替代示踪剂，注入卵巢的悬韧带和骨盆漏斗韧带。
