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Feasibility of Sentinel Lymph Node Sampling in Early-Stage Carcinoma Endometrium: Single-Institution Experience

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Abstract

Introduction

Accurate surgical staging is an essential component in the management of carcinoma endometrium to assess the stage of disease and to tailor adjuvant treatment. Sentinel node technique was introduced as an alternative for extensive lymphadenectomy in early stages to avoid complications associated with lymphadenectomy.

Aims and Objectives

To assess the detection rate and diagnostic accuracy of SLN mapping in patients with early-stage carcinoma endometrium

Materials and Methods

Prospective validation study involving 30 patients diagnosed to have early-stage carcinoma endometrium. Sentinel nodes were detected by combined methods of radio colloid dye and isosulphan blue dye injection

Results

Sentinel lymph node was detected in 19 patients (63.4%). 11 patients had no sentinel nodes. Total number of sentinel nodes isolated was 68 with a mean of 2.26 per patient (range 0–4). Ten (33.33%) patients had single sentinel node location, while 9 (30%) had more than 1 sentinel lymph nodes. Twelve patients had bilateral sentinel nodes, and the most frequent location of sentinel node was obturator, 19 (63.3%) especially on right hemi-pelvis. One patient had a hot para-aortic node, while none had blue para-aortic sentinel node. Average number of lymph nodes obtained by lymphadenectomy was 13 per patient (range 7–22). All patients with sentinel node had negative frozen report as well as in histopathology. Two patients in whom no sentinel nodes were detected by either techniques had metastatic nodes in histopathology report.

Conclusion

Detection rate was maximum with radiocolloid dye, and it is better to utilize the technique for less graded tumours and endometrioid variants.

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Funding

Funding Sponsored by institute, RCC, Thiruvananthapuram, Kerala.

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Authors and Affiliations

  1. Division of Gynaecological Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Aswathy G. Nath, S. Suchetha & P. Rema

  2. Department of Nuclear Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    V. M. Pradeep

  3. Division of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    J. Sivaranjith

  4. Department of Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Jagathnath Krishna

  5. Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Rari P. Mony

Authors
  1. Aswathy G. Nath
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  2. S. Suchetha
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  3. V. M. Pradeep
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  4. P. Rema
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  5. J. Sivaranjith
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  7. Rari P. Mony
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Corresponding author

Correspondence to S. Suchetha.

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Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose.

Ethical Statement

This study was conducted after Institute review board and Ethical committee clearance—IRB no. 12/2016/09, HEC no. 03/2017.

Informed Consent

Informed consent was obtained from all the participants in this study.

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Aswathy G Nath is a Senior Resident at Division of Gynaecological Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India; S. Suchetha is an Additional Professor at Division of Gynaecological Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India; V. M. Pradeep is a Professor and Head at Department of Nuclear Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala, India; P. Rema is an Additional Professor at Division of Gynaecological Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India; J. Sivaranjith is an Assistant Professor at Division of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India; Jagathnath Krishna is an Assistant Professor at Department of Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India; Rari P. Mony is an Assistant Professor at Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.

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Nath, A.G., Suchetha, S., Pradeep, V.M. et al. Feasibility of Sentinel Lymph Node Sampling in Early-Stage Carcinoma Endometrium: Single-Institution Experience. J Obstet Gynecol India 72, 341–345 (2022). https://doi.org/10.1007/s13224-021-01530-w

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  • DOI: https://doi.org/10.1007/s13224-021-01530-w

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