Sentinel lymph node biopsy

 

Sentinel lymph node biopsy

25 Jul, 2019

Lymph node metastasis is the most important prognostic factor for recurrence and death and is a major determinant of treatment.

A sentinel lymph node is defined as the first lymph node to which cancer cells are most likely to spread from a primary tumor.

Most patients of cancer endometrium are obese and lymphadenectomy attracts :

  • Technical difficulty
  • Vascular injury
  • Morbidity asscociated with lymphedema

The Role of Sentinel Lymph Node Mapping in Endometrial Cancer

  • Complete lymph node removal procedures have been associated with increased morbidity including lymphocysts, lymphedema (limb swelling), and varying degrees of both short and long-term neuralgia.
  • Furthermore, two phase III trials failed to demonstrate a survival benefit with pelvic and selective aortic lymphadenectomy in patients with endometrial cancer.
  • Sentinel lymph node (SLN) mapping and ultrastaging of sentinel nodes has been proposed by many gynaecologic oncologists as a method to potentially decrease morbidity while maintaining prognostic information of lymph node status.

The technique involves dye injection into the cervix at 3 and 9 o clock position and then harvesting lymph nodes by following the tract from the pelvic basin. In case sentinel lymph node is not harvested, complete lymphadenectomy is warranted on that side.

It’s a simple, cost effective and oncologically safe technique in the management of endometrial cancer.

Categories >> Endometrial Cancer