A feasibility study of sentinel lymph node mapping by cervical injection of a tracer in Japanese women with early stage endometrial cancer

• Published in: Taiwanese journal of obstetrics & gynecology 2018-08, Vol.57 (4), p.541-545
• Main Authors: Shimada, Chisa, Todo, Yukiharu, Yamazaki, Hiroyuki, Takeshita, Sho, Okamoto, Kazuhira, Minobe, Shinichiro, Yamashiro, Katsushige, Kato, Hidenori
• Format: Article
• Language: English
• Subjects: Cervical injection; Endometrial cancer; Sensitivity; Sentinel lymph node; Uterine cancer
• ISSN: 1028-4559
• DOI: 10.1016/j.tjog.2018.06.012

The aim of this study was to investigate the feasibility of sentinel lymph node mapping characterized by a cervical tracer injection in endometrial cancer. This retrospective study was carried out using data for 57 patients with endometrial carcinoma who had undergone intraoperative sentinel lymph node mapping and subsequent surgical staging. Technetium colloid and/or indocyanine green was injected into the uterine cervix and a gamma-detecting probe and/or photodynamic eye camera system was used intraoperatively to locate hot spots. Of the 57 patients, 52 (91.2%) had FIGO Stage I disease. Successful unilateral or bilateral mapping occurred in 54 patients (94.7%) and 46 (80.7%), respectively. The median number of sentinel lymph nodes detected was two (range, 0–5). Following sentinel lymph node mapping, 41 patients (71.9%) underwent pelvic lymphadenectomy alone and 16 (28.1%) full lymphadenectomy. The median number of lymph nodes resected was 17 (range, 8–110). Sentinel lymph nodes were involved in four patients (7.0%), two with macrometastases and two with low-volume metastases. The sensitivity and negative predictive value for detecting lymph node metastasis were both 100%. Sentinel lymph node mapping with the use of cervical tracer injection is highly feasible in Japanese women with early stage endometrial cancer.