Sentinel lymph node mapping in endometrial cancer: a systematic review and meta-analysis

Lin, Hefeng; Ding, Zheyuan; Kota, Vishnu Goutham; Zhang, Xiaoming; Zhou, Jianwei

doi:10.18632/oncotarget.16662

Cited by 71 publications

(52 citation statements)

References 61 publications

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“…The detection rate for ICG alone is reported between 82% and 100% . In the recent meta‐analysis by Lin et al ., the overall detection rate was 93% (89–96%), the bilateral detection rate was 78% (72–84%) and the sensitivity rate was 87% (76–93%) . Robotic and laparoscopic surgery were associated with higher determination rates and sensitivities compared to open surgery …”

Section: Discussionmentioning

confidence: 96%

“…Sentinel lymph node biopsy is one of the best choices for patients with low risk endometrial cancer to decrease unnecessary morbidity. The sensitivity and bilateral detection rate for blue dye were 90% (95% CI: 79–96%) and 44% (95% CI: 38–50%), respectively and both blue dye and Tc‐99m were used for mapping 92% (95% CI: 84–96%) and 56% (95% CI: 41–71%), respectively . In the literature, the rate of bilateral SLN determination is higher for ICG than for blue dye or Tc‐99m, and between 19% and 89% .…”

Section: Discussionmentioning

confidence: 97%

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Failure of sentinel lymph node mapping in a patient with endometrial cancer with chronic lymphocytic leukemia: A case report

Vatansever

Giray

Kumcular

et al. 2019

J of Obstet and Gynaecol

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We aimed to report a detection failure of sentinel lymph node (SLN) mapping via indocyanine green in a patient with endometrial cancer with a previous history of chronic lymphocytic leukemia (CLL), which is a potential risk factor to obstruct lymphatic channels. A 64-year-old woman with a 12-year history of CLL presented to the clinic with grade 2 endometrioid carcinoma. The patient underwent laparoscopic surgical staging. Indocyanine green was used intraoperatively to locate the SLN. No lymph node or lymphatic vessels were identified during SLN mapping. At the final pathology, the morphological findings of CLL were detected in the lymph nodes without metastasis of endometrial cancer. Sentinel lymph node mapping failure due to obstruction of lymphatic channels in a patient with CLL was demonstrated in this study. This is the first report to the best of our knowledge showing SLN mapping failure in the presence of lymphoproliferative diseases.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Failure of sentinel lymph node mapping in a patient with endometrial cancer with chronic lymphocytic leukemia: A case report

Vatansever

Giray

Kumcular

et al. 2019

J of Obstet and Gynaecol

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“…The detection rate (87 vs. 88%; p = 0.83) and bilaterality (71 vs. 65%; p = 0.36) achieved with ICG and the radiocolloid were comparable to the data obtained with only an injection of ICG. In the meta-analysis by Lin et al [73], the combined technique with 99m Tc and ICG achieved a detection rate of 92% and bilaterality of 86%, results comparable to those using only ICG (91% and 78%, respectively).…”

Section: Radiocolloid and Icgmentioning

confidence: 93%

Role of Sentinel Node Biopsy in Endometrial Cancer

Noval¹

2020

Current Cancer Treatment

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Lymphadenectomy, for early stages of endometrial cancer (EC), provides a low detection rate of lymphatic metastasis, without having demonstrated a therapeutic effect; so that the collection and histological analysis of the sentinel lymph node (SLN) might be an alternative to lymphadenectomy. The contribution of SLN to surgical staging represents a change in the paradigm of lymphadenectomy in EC, being an intermediate approach between not assessing the condition of the lymph nodes and complete pelvic and paraaortic dissection. Accurate identification of the main uterine drainage pathway increases the likelihood of detecting metastases during lymphatic mapping. In addition, pathological assessment by the ultrastaging of the SLN is the most important advance in the SLN biopsy (SLNB) technique. The application of the SLNB presumes a decrease in surgical and long-term morbidity, with an increase in the detection of lymphatic metastasis, mainly at the expense of detecting low tumour volume, selecting the group of patients that would benefit from a modification in adjuvant therapy. The SLNB can be established as an oncologically safe and effective method in the surgical staging of early-stage EC. Prospective studies are required to determine optimal behaviour and prognosis in the detection of low-volume metastases.Keywords: endometrial cancer, lymphatic mapping, predictive value of tests, sentinel lymph node biopsy, ultrastaging This information, provided by SLN, will change the therapeutic approach, with a potential benefit in the prognosis, both in survival and quality of life [6]. Detection methodTheoretically, the ideal method for studying SLN in EC should meet the following requirements:1. Cause the least amount of patient discomfort possible, be easy to perform and be reproducible.2. Be a preoperative procedure that enables planning of the surgical approach according to the anatomical location of the SLN.3. Enable a laparoscopic approach according to the concept of minimally invasive surgery.4. Enable the detection of SLN without complete dissection of the retroperitoneal space.5. Obtain a lymphatic map representative of the tumour drainage or, at least, of the uterine body drainage [7]. Lymphatic drainage of the uterusUnlike superficial tumours, such as melanoma, the physiology of lymphatic drainage in deeper/visceral tumours is not well established [8]. Uterine drainage, as well as being bilateral, is therefore complex [9]. Anatomically, three segments of uterine lymphatic drainage have been established:1. The lower uterine segment drains from the paracervix to the parametrium and to the broad ligament, passing by the obturator, internal iliac and interiliac lymph node chains.2. The middle third of the uterus drains the round ligament and the external iliac lymph node chain.3. The upper uterine segment drains through the infundibular pelvic ligament, uterine-ovarian plexus and gonadal vessels towards the common iliac lymph node chain, presacral lymph nodes and paraaortic lymph nodes [10].Physiologically, there a...

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“…However, it has also been shown that lower extremity lymphedema following comprehensive lymphadenectomy has a negative impact on quality of life. 6 In recent studies, sentinel lymph node (SLN) mapping has been reported as an accepted procedure to avoid comprehensive lymphadenectomy in endometrial cancer, [7][8][9][10][11][12][13][14][15] and it has been suggested that SLN biopsy could be a viable alternative to systematic lymphadenectomy in patients with low-risk and intermediate-risk endometrial cancer. 16 Reports in the literature have cited a high SLN detection rate of 89%-89.8% and a bilateral detection rate of 58%-63.2% for SLN biopsy in high-risk endometrial cancer.…”

Section: Introductionmentioning

confidence: 99%