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The Role of Sentinel Node Dissection

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Management of Endometrial Cancer

Abstract

Hysterectomy with bilateral salpingo-oophorectomy and complete surgical staging by lymph node dissection has been recommended as the standard of care for apparent early-stage endometrial cancer in many national guidelines since 1985 [1]. Other, mainly European, guidelines include neither a lymph node dissection nor lymph node sampling. Whether to perform a lymph node dissection has been one of the most controversial areas in the management of endometrial cancer. Moreover, the extent of the lymph node dissection is of ongoing debate, such as pelvic versus pelvic and para-aortic; below versus above the inferior mesenteric artery; complete lymphadenectomy versus lymph node sampling.

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References

  1. Creasman WT, Odicino F, Maisonneuve P, Quinn MA, Beller U, Benedet JL, Heintz AP, Ngan HY, Pecorelli S. Carcinoma of the corpus uteri. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet. 2006;95(Suppl 1):S105–43.

    Article  Google Scholar 

  2. Benedetti Panici P, Basile S, Maneschi F, Alberto Lissoni A, Signorelli M, Scambia G, Angioli R, Tateo S, Mangili G, Katsaros D, Garozzo G, Campagnutta E, Donadello N, Greggi S, Melpignano M, Raspagliesi F, Ragni N, Cormio G, Grassi R, Franchi M, Giannarelli D, Fossati R, Torri V, Amoroso M, Crocè C, Mangioni C. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2008;100(23):1707–16.

    Article  Google Scholar 

  3. Sharma C, Deutsch I, Lewin SN, Burke WM, Qiao Y, Sun X, Chao CK, Herzog TJ, Wright JD. Lymphadenectomy influences the utilization of adjuvant radiation treatment for endometrial cancer. Am J Obstet Gynecol. 2011;205(6):562.

    Article  Google Scholar 

  4. ASTEC Study Group, Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373(9658):125–36.

    Article  Google Scholar 

  5. Frost JA, Webster KE, Bryant A, Morrison J. Lymphadenectomy for the management of endometrial cancer. Cochrane Database Syst Rev. 2015;9:CD007585.

    Google Scholar 

  6. Barakat RR, Lev G, Hummer AJ, Sonoda Y, Chi DS, Alektiar KM, Abu-Rustum NR. Twelve-year experience in the management of endometrial cancer: a change in surgical and postoperative radiation approaches. Gynecol Oncol. 2007;105(1):150–6.

    Article  Google Scholar 

  7. Gould EA, Winship T, Philbin PH, Kerr HH. Observations on a “sentinel node” in cancer of the parotid. Cancer. 1960;13:77–8.

    Article  CAS  Google Scholar 

  8. Cody HS. Sentinel lymph node mapping in breast cancer. Breast Cancer. 1999;6(1):13–22.

    Article  CAS  Google Scholar 

  9. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, Foshag LJ, Cochran AJ. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127(4):392–9.

    Article  CAS  Google Scholar 

  10. Khoury-Collado F, Murray MP, Hensley ML, Sonoda Y, Alektiar KM, Levine DA, Leitao MM, Chi DS, Barakat RR, Abu-Rustum NR. Sentinel lymph node mapping for endometrial cancer improves the detection of metastatic disease to regional lymph nodes. Gynecol Oncol. 2011;122(2):251–4.

    Article  CAS  Google Scholar 

  11. Frumovitz M, Levenback CF. Is lymphatic mapping in uterine cancer feasible? Ann Surg Oncol. 2008;15:1815.

    Article  Google Scholar 

  12. Robison K, Holman LL, Moore RG. Update on sentinel lymph node evaluation in gynecologic malignancies. Curr Opin Obstet Gynecol. 2011;23:8.

    Article  Google Scholar 

  13. Burke TW, Levenback C, Tornos C, et al. Intraabdominal lymphatic mapping to direct selective pelvic and paraaortic lymphadenectomy in women with high-risk endometrial cancer: results of a pilot study. Gynecol Oncol. 1996;62:169–73.

    Article  CAS  Google Scholar 

  14. Niikura H, Okamura C, Utsunomiya H, et al. Sentinel lymph node detection in patients with endometrial cancer. Gynecol Oncol. 2004;92:669–74.

    Article  Google Scholar 

  15. Clement D, Bats AS, Ghazzar-Pierquet N, Le Frere Belda MA, Larousserie F, Nos C, Lecuru F. Sentinel lymph nodes in endometrial cancer: is hysteroscopic injection valid? Eur J Gynaecol Oncol. 2008;29(3):239–41.

    CAS  PubMed  Google Scholar 

  16. Zivanovic O, Khoury-Collado F, Abu-Rustum NR, Gemignani ML. Sentinel lymph node biopsy in the management of vulvar carcinoma, cervical cancer, and endometrial cancer. Oncologist. 2009;14(7):695–705. https://doi.org/10.1634/theoncologist.2009-0075. Epub 2009 Jul 16.

    Article  PubMed  Google Scholar 

  17. Kang S, Yoo HJ, Hwang JH, et al. Sentinel lymph node biopsy in endometrial cancer: meta-analysis of 26 studies. Gynecol Oncol. 2011;123:522.

    Article  Google Scholar 

  18. Abu-Rustum NR. Sentinel lymph node mapping for endometrial cancer: a modern approach to surgical staging. J Natl Compr Cancer Netw. 2014;12(2):288–97.

    Article  Google Scholar 

  19. Bodurtha Smith AJ, Fader AN, Tanner EJ. Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216:459–476.e10.

    Article  Google Scholar 

  20. Plante M, Touhami O, Trinh XB, Renaud MC, Sebastianelli A, Grondin K, Gregoire J. Sentinel node mapping with indocyanine green and endoscopic near-infrared fluorescence imaging in endometrial cancer. A pilot study and review of the literature. Gynecol Oncol. 2015;137(3):443–7.

    Article  Google Scholar 

  21. Holloway RW, Ahmad S, Kendrick JE, Bigsby GE, Brudie LA, Ghurani GB, Stavitzski NM, Gise JL, Ingersoll SB, Pepe JW. A prospective cohort study comparing colorimetric and fluorescent imaging for sentinel lymph node mapping in endometrial cancer. Ann Surg Oncol. 2017;24:1972. https://doi.org/10.1245/s10434-017-5825-3.

    Article  PubMed  Google Scholar 

  22. Geppert B, Lonnerfors C, Bollino M, Arechvo A, Persson J. A study on uterine lymphatic anatomy for standardization of pelvic sentinel lymph node detection in endometrial cancer. Gynecol Oncol. 2017;145:256.

    Article  Google Scholar 

  23. Rossi EC, Kowalski LD, Scalici J, Cantrell L, Schuler K, Hanna RK, Method M, Ade M, Ivanova A, Boggess JF. A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study. Lancet Oncol. 2017;18(3):384–92.

    Article  Google Scholar 

  24. Vidal F, Leguevaque P, Motton S, Delotte J, Ferron G, Querleu D, Rafii A. Evaluation of the sentinel lymph node algorithm with blue dye labeling for early-stage endometrial cancer in a multicentric setting. Int J Gynecol Cancer. 2013;23(7):1237–43.

    Article  Google Scholar 

  25. Barlin JN, Khoury-Collado F, Kim CH, Leitao MM Jr, Chi DS, Sonoda Y, Alektiar K, DeLair DF, Barakat RR, Abu-Rustum NR. The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: beyond removal of blue nodes. Gynecol Oncol. 2012;125(3):531–5.

    Article  Google Scholar 

  26. Cormier B, Rozenholc AT, Gotlieb W, Plante M, Giede C, Communities of Practice (CoP) Group of Society of Gynecologic Oncology of Canada (GOC). Sentinel lymph node procedure in endometrial cancer: a systematic review and proposal for standardization of future research. Gynecol Oncol. 2015;138(2):478–85.

    Article  Google Scholar 

  27. Mariani A, Dowdy SC, Cliby WA, Gostout BS, Jones MB, Wilson TO, Podratz KC. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol. 2008;109(1):11–8.

    Article  Google Scholar 

  28. Cote RJ, Peterson HF, Chaiwun B, et al. Role of immunohistochemical detection of lymph-node metastases in management of breast cancer. International Breast Cancer Study Group. Lancet. 1999;354:896–900.

    Article  CAS  Google Scholar 

  29. Roy M, Bouchard-Fortier G, Popa I, Grégoire J, Renaud MC, Têtu B, Plante M. Value of sentinel node mapping in cancer of the cervix. Gynecol Oncol. 2011;122(2):269–74.

    Article  Google Scholar 

  30. Abu-Rustum NR. The increasing credibility of sentinel lymph node mapping in endometrial cancer. Ann Surg Oncol. 2013;20(2):353–4.

    Article  Google Scholar 

  31. Bezu C, Coutant C, Ballester M, et al. Ultrastaging of lymph node in uterine cancers. J Exp Clin Cancer Res. 2010;29:5.

    Article  Google Scholar 

  32. Delpech Y, Cortez A, Coutant C, et al. The sentinel node concept in endometrial cancer: histopathologic validation by serial section and immunohistochemistry. Ann Oncol. 2007;18:1799–803.

    Article  CAS  Google Scholar 

  33. Kim CH, et al. Sentinel lymph node mapping with pathologic ultrastaging: a valuable tool for assessing nodal metastasis in low-grade endometrial cancer with superficial myoinvasion. Gynecol Oncol. 2013;131(3):714.

    Article  Google Scholar 

  34. Wu Y, Li Z, Wu H, et al. Sentinel lymph node biopsy in cervical cancer: a meta-analysis. Mol Clin Oncol. 2013;1:1025–30.

    Article  Google Scholar 

  35. Ballester M, Dubernard G, Rouzier R, Barranger E, Darai E. Use of the sentinel node procedure to stage endometrial cancer. Ann Surg Oncol. 2008;15(5):1523–9.

    Article  Google Scholar 

  36. Tjan-Heijnen VC, Pepels MJ, de Boer M. Prognostic impact of isolated tumor cells and micrometastases in axillary lymph nodes of breast cancer patients. Breast Dis. 2010;31:107–13.

    Article  Google Scholar 

  37. Marchiole P, Buenerd A, Benchaib M, Nezhat K, Dargent D, Mathevet P. Clinical significance of lympho vascular space involvement and lymph node micrometastases in early-stage cervical cancer: a retrospective case-control surgico-pathological study. Gynecol Oncol. 2005;97:727–32.

    Article  Google Scholar 

  38. Oonk MH, Hollema H, van der Zee AG. Sentinel node biopsy in vulvar cancer: implications for staging. Best Pract Res Clin Obstet Gynaecol. 2015;29(6):812–21.

    Article  CAS  Google Scholar 

  39. Erkanli S, Bolat F, Seydaoglu G. Detection and importance of micrometastasis in histologically negative lymph nodes in endometrial carcinoma. Eur J Gynaecol Oncol. 2011;32(6):619–25.

    CAS  PubMed  Google Scholar 

  40. Yabushita H, Shimazu M, Yamada H, et al. Occult lymph node metastases detected by cytokeratin immunohistochemistry predict recurrence in node-negative endometrial cancer. Gynecol Oncol. 2001;80:139–44.

    Article  CAS  Google Scholar 

  41. McCoy A, Finan MA, Boudreaux FT, Tucker JA, Lazarchick JJ, Donnell RM, Rocconi RP. The incidence and clinical significance of lymph node micrometastases determined by immunohistochemical staining in stage I—lymph node negative endometrial cancer. Histol Histopathol. 2012;27(2):181–5.

    PubMed  Google Scholar 

  42. Raimond E, et al. Impact of sentinel lymph node biopsy on the therapeutic management of early-stage endometrial cancer: results of a retrospective multicenter study. Gynecol Oncol. 2014;133:506–11.

    Article  Google Scholar 

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Correspondence to Petra Zusterzeel .

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Zusterzeel, P., Aarts, A., Kasiu, J., Vergeldt, T. (2020). The Role of Sentinel Node Dissection. In: Mirza, M. (eds) Management of Endometrial Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-64513-1_12

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  • DOI: https://doi.org/10.1007/978-3-319-64513-1_12

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