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A Prospective Study of Role of Sentinel Lymph Node Biopsy in Low-Risk/Intermediate-Risk Early-Stage Endometrial Carcinoma Using Dual-Dye and Dual-Site and Injection Technique

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

This is a prospective study aimed to identify the role of sentinel lymph node biopsy in low-/intermediate-risk early-stage endometrial carcinoma and its correlation with pathological findings using dual-dye and dual-site and injection technique.

Materials and Methods

It is a prospective observational study conducted in a tertiary cancer care centre for treatment of endometrial carcinoma in the period from June 2015 to June 2017. All the patients qualifying preoperative inclusion criteria for the study with biopsy-proven case of endometrial carcinoma were enrolled. Dual-dye and dual-site intervention: both radiotracer dye (Tc 99 nanocolloidal albumin dye) and methylene blue was selected for injection at two sites—cervix and subserosal.

Results

A total of 32 patients were enrolled. The median age of patients was 58.5 years (range 25–72). Histological tumour grade was available at preoperative histology in 25 of the 32 patients included in the protocol (78%). Detection rate using combined cervical and subserosal injection per patient was 96.8%. Among the patient with SLN detected in pelvic area, detection was unilateral in 6 patients (19%) and bilateral in 25 cases (78%). Sentinel lymph node detection in right and left hemi-pelvis was 81% (26 cases) and 94% (30 cases), respectively. At least one sentinel lymph node is identified in 31 of 32 patients. Metastasis was noted in 6 patients out of 32 patients. Sentinel lymph nodes are identified in all 6 of these patients.

Conclusion

The present study suggests that sentinel node biopsy is an adequate technique to evaluate lymph node status in early-stage disease with detection rate more than 95%, sensitivity of 100% and false negative rate of zero. With the low morbidity of the SLNB procedure, it might be desirable if all women with low- and intermediate-risk early-stage disease could undergo SLNB to help in the selecting those who actually benefits from comprehensive lymphadenectomy. The use of both cervical and subserosal techniques of injection of dye is associated with high overall and para-aortic SLN detection rate than either of them separately.

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Authors and Affiliations

  1. Department of Surgical Oncology, Max Institute of Cancer Care, Saket, India

    Vikas Singh & Lourembam Sunil Singh

  2. Department of Gynaecologic Oncology, Max Institute of Cancer Care, Max Super Speciality Hospital, Room No. 5, East Block, Saket, India

    Amish Chaudhary & Kanika Batra Modi

  3. Department of Obstetrics and Gynaecology, Anandlok Hospital, Kolkata, India

    Lahori Roy

  4. Department of Nuclear Medicine, Max Institute of Cancer Care, Saket, India

    Pankaj Dougall

  5. Department of Radiology, Max Institute of Cancer Care, Saket, India

    Gurpreet Makkar

  6. Department of Pathology, Max Institute of Cancer Care, Saket, India

    Andleeb Abrari

  7. Max Group of Oncology, Surgical Oncology, Max Institute of Cancer Care, Saket, India

    Harit Chaturvedi

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  1. Vikas Singh
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Singh, V., Chaudhary, A., Modi, K.B. et al. A Prospective Study of Role of Sentinel Lymph Node Biopsy in Low-Risk/Intermediate-Risk Early-Stage Endometrial Carcinoma Using Dual-Dye and Dual-Site and Injection Technique. Indian J Gynecol Oncolog 17, 32 (2019). https://doi.org/10.1007/s40944-019-0262-9

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