Basaran Derman, Leitao Mario M
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Joan & Sanford I. Weill Medical College of Cornell University, New York, NY, USA.
Indian J Gynecol Oncol. 2020 Jun;18(2). doi: 10.1007/s40944-020-00386-8. Epub 2020 Apr 13.
Surgery is the mainstay of treatment for the majority of patients diagnosed with endometrial carcinoma. Systematic lymphadenectomy has traditionally been considered a standard part of surgical therapy. More recently, however, the value of this has been a subject of much debate. The sentinel lymph node (SLN) mapping algorithm has emerged as an acceptable alternative to conventional pelvic and para-aortic lymph node dissection in endometrial cancer. Clinical trials have demonstrated the accuracy of SLN mapping in detecting nodal spread in patients with endometrial cancer. However, data regarding the oncological outcomes of this approach, particularly in the setting of endometrial cancer with a high risk of nodal spread, is still lacking. In this review, we provide an overview of SLN mapping in endometrial cancer. We will specifically discuss its use in patients with a high risk for nodal metastasis. Controversies and future directions for research will also be discussed.
手术是大多数被诊断为子宫内膜癌患者的主要治疗手段。传统上，系统性淋巴结清扫一直被视为手术治疗的标准组成部分。然而，最近其价值一直是诸多争论的主题。前哨淋巴结（SLN）定位算法已成为子宫内膜癌中传统盆腔和腹主动脉旁淋巴结清扫的可接受替代方法。临床试验已证明SLN定位在检测子宫内膜癌患者淋巴结转移方面的准确性。然而，关于这种方法的肿瘤学结局的数据，特别是在淋巴结转移风险高的子宫内膜癌情况下，仍然缺乏。在本综述中，我们概述了子宫内膜癌中的SLN定位。我们将特别讨论其在淋巴结转移高风险患者中的应用。还将讨论争议点和未来的研究方向。
