Laparoscopic Sentinel Node Procedure Using a Combination of Patent Blue and Radiocolloid in Women With Endometrial Cancer
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Background: We assessed the feasibility of a laparoscopic sentinel node (SN) procedure based on the combined use of radiocolloid and patent blue labeling in patients with endometrial cancer.
Methods: Seventeen patients (median age, 69 years) with endometrial cancer of stage I (16 patients) or stage II (1 patient) underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically. After the SN procedure, all patients underwent complete laparoscopic pelvic lymphadenectomy and either laparoscopically assisted vaginal hysterectomy (16 patients) or laparoscopic radical hysterectomy (1 patient).
Results: SNs (mean number per patient, 2.6; range, 1–4) were identified in 16 (94.1%) of the 17 patients. Macrometastases were detected in three SNs from two patients by hematoxylin and eosin staining. In three other patients, immunohistochemical analysis identified six micrometastatic SNs and one SN containing isolated tumor cells. No false-negative SN results were observed.
Conclusions: An SN procedure based on a combination of radiocolloid and patent blue is feasible in patients with early endometrial cancer. Combined use of laparoscopy and this SN procedure permits minimally invasive management of endometrial cancer.
- Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin 2001;51:15–36. CrossRef
- Annual report on the results of treatment in gynecologic cancer. Int J Gynaecol Obstet 1989;28:189–90.
- Disaia PJ, Creasman WT, Boronow RC, Blessing JA. Risk factors and recurrent patterns in stage I endometrial cancer. Am J Obstet Gynecol 1985;151:1009–15.
- American Joint Committee on Cancer. Manual for Staging of Cancer. 4th ed. Philadelphia: Lippincott, 1992:155–7.
- Masubuchi S, Fujimoto I, Masubuchi K. Lymph node metastasis and prognosis of endometrial carcinoma. Gynecol Oncol 1979;7:36–46.
- Figge DC, Otto PM, Tamimi HK, Greer BE. Treatment variables in the management of endometrial cancer. Am J Obstet Gynecol 1983;146:495–500.
- Boronow RC, Morrow CP, Creasman WT, et al. Surgical staging in endometrial cancer: clinical-pathologic findings of a prospective study. Obstet Gynecol 1984;63:825–32.
- Descamps P, Calais G, Vitu L, Body G, Lansac J. Stage I and II endometrial adenocarcinomas. Prognostic value of lymph node invasion (in French). J Gynecol Obstet Biol Reprod 1991;20:223–9.
- Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group study. Cancer 1987;60(8 Suppl):2035–41.
- Wallin TE, Malkasian GDJ, Gaffey TA, O’Brien PC, Fountain KS. Stage II cancer of the endometrium: a pathologic and clinical study. Gynecol Oncol 1984;18:1–17.
- Corn BW, Lanciano RM, Greven KM, et al. Impact of improved irradiation technique, age, and lymph node sampling on the severe complication rate of surgically staged endometrial cancer patients: a multivariate analysis. J Clin Oncol 1994;12:510–5.
- Arduino S, Leo L, Febo G, Tessarolo M, Wierdis T, Lanza A. Complications of pelvic and para-aortic lymphadenectomy in patients with endometrial cancer. Eur J Gynaecol Oncol 1997;18:208–10.
- Gould EA, Winship T, Philbin PH, Kerr H. Observations on a “sentinel node” in the parotid. Cancer 1960;13:77–8.
- Levenback C, Burke TW, Gershenson DM, Morris M, Malpica A, Ross MI. Intraoperative lymphatic mapping for vulvar cancer. Obstet Gynecol 1994;84:163–7.
- De Hullu JA, Hollema H, Piers DA, et al. Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva. J Clin Oncol 2000;18:2811–6.
- Levenback C, Coleman RL, Burke TW, Bodurka-Bevers D, Wolf JK, Gershenson DM. Intraoperative lymphatic mapping and sentinel node identification with blue dye in patients with vulvar cancer. Gynecol Oncol 2001;83:276–81.
- O’Boyle JD, Coleman RL, Bernstein SG, Lifshitz S, Muller CY, Miller DS. Intraoperative lymphatic mapping in cervix cancer patients undergoing radical hysterectomy: a pilot study. Gynecol Oncol 2000;79:238–43.
- Dargent D, Martin X, Mathevet P. Laparoscopic assessment of the sentinel lymph node in early stage cervical cancer. Gynecol Oncol 2000;79:411–5. CrossRef
- Levenback C, Coleman RL, Burke TW, et al. Lymphatic mapping and sentinel node identification in patients with cervix cancer undergoing radical hysterectomy and pelvic lymphadenectomy. J Clin Oncol 2002;20:688–93.
- Verheijen RH, Pijpers R, van Diest PJ, Burger CW, Buist MR, Kenemans P. Sentinel node detection in cervical cancer. Obstet Gynecol 2000;96:135–8. CrossRef
- Lantzsch T, Wolters M, Grimm J, et al. Sentinel node procedure in Ib cervical cancer: a preliminary series. Br J Cancer 2001;85:791–4.
- Barranger E, Grahek D, Cortez A, Uzan S, Darai E. Laparoscopic sentinel node procedure in patients with cervical cancer. J Clin Oncol 2002;20:2602–3.
- Barranger E, Grahek D, Cortez A, Talbot JN, Uzan S, Darai E. Laparoscopic sentinel lymph node procedure using a combination of patent blue and radioisotope in women with cervical carcinoma. Cancer 2003;97:3003–9.
- Burke TW, Levenback C, Tornos C, Morris M, Wharton JT, Gerhenson D. Intraabdominal lymphatic mapping to direct selective pelvic and paraaortic lymphadenectomy in patients with high risk endometrial cancer: results of a pilot study. Gynecol Oncol 1996;62:169–73. CrossRef
- Echt ML, Finan MA, Hoffman MS, Kline RC, Roberts WS, Fiorica JV. Detection of sentinel lymph nodes with lymphazurin in cervical, uterine, and vulvar malignancies. South Med J 1999;92:204–8.
- Holub Z, Jabor A, Kliment L. Comparison of two procedures for sentinel lymph node detection in patients with endometrial cancer: a pilot study. Eur J Gynaecol Oncol 2002;1:53–7.
- Pelosi E, Arena V, Baudino B, et al. Preliminary study of sentinel node identification with 99mTc colloid and blue dye in patients with endometrial cancer. Tumori 2002;88:S9–10.
- Bremond A, Bataillard A, Thomas L, et al. Cancer of the endometrium. Br J Cancer 2001;84(Suppl 2):31–6.
- Leveuf J, Godard H. Lymphatic drainage of the uterus (in French). Rev Chir 1923;61:219–48.
- Lecuru F, Neji K, Robin F, Darles C, de Bièvre P, Taurelle R. Lymphatic drainage of the uterus: preliminary results of an experimental study (in French). J Gynecol Obstet Biol Reprod 1997;26:418–23.
- Flanagan CW, Mannel RS, Walker JL, Johnson GA. Incidence and location of para-aortic lymph node metastases in gynecologic malignancies. J Am Coll Surg 1995;181:72–4.
- Mariani A, Webb MJ, Keeney GL, Pdratz KC. Routes of lymphatic spread: a study of 112 consecutive patients with endometrial cancer. Gynecol Oncol 2001;81:100–4.
- Michel G, Morice P, Castaigne D, Leblanc M, Rey A, Duvillard P. Lymphatic spread in stage Ib and II cervical carcinoma: anatomy and surgical implications. Obstet Gynecol 1998;91:360–3.
- Stitzenberg KB, Calvo BF, Iacocca MV, et al. Cytokeratin immunohistochemical validation of the sentinel node hypothesis in patients with breast cancer. Am J Clin Pathol 2002;117:729–37.
- Yabushita H, Shimazu M, Yamada H, Sawaguchi K, Nogushi M, Nakanishi M. Occult lymph node metastases detected by cytokeratin immunohistochemistry predict recurrence in node-negative endometrial cancer. Gynecol Oncol 2001;80:139–44.
- Laparoscopic Sentinel Node Procedure Using a Combination of Patent Blue and Radiocolloid in Women With Endometrial Cancer
Annals of Surgical Oncology
Volume 11, Issue 3 , pp 344-349
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- Sentinel node
- Patent blue
- Endometrial cancer
- Industry Sectors
- Author Affiliations
- 1. Departments of Gynecologic and Breast Cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France
- 4. Department of Gynecologic and Breast Cancers, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France
- 2. Departments of Pathology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France
- 3. Departments of Nuclear Medicine, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France