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Intraoperative sentinel lymph node detection by vital dye through laparoscopy or laparotomy in early endometrial cancer
Author(s) -
Mais Valerio,
Peiretti Michele,
Gargiulo Tigellio,
Parodo Giuseppina,
Cirronis Maria Giuseppina,
Melis Gian Benedetto
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21496
Subject(s) - medicine , laparotomy , endometrial cancer , laparoscopy , stage (stratigraphy) , lymph node , lymphadenectomy , sentinel lymph node , surgery , sentinel node , cancer , general surgery , breast cancer , paleontology , biology
Background and Objectives Recent studies reported the feasibility of intraoperative lymphatic mapping in women with endometrial cancer but none of these studies compared the sentinel lymph nodes (SLNs) detection rates obtainable through laparoscopy or laparotomy. The purpose of this study was to address this issue. Methods Thirty‐four patients with clinical stage I–II endometrial cancer were enrolled in this prospective comparative trial. Four milliliters of Patent Blue Violet were injected into the cervix after the induction of general anesthesia. The assessment of SLNs was done in 17 patients through laparoscopy and in 17 patients through laparotomy as first step of systematic pelvic lymphadenectomy. Both SLNs and non‐SLNs were evaluated for micrometastases. Results The SLNs detection rate was significantly higher (82%) for laparoscopy than for laparotomy (41%; P = 0.008). Pelvic lymph node metastases were present in 6 out of 34 patients (18%) but only 3 (50%) of these patients were correctly identified. Conclusions SLNs detection rate is significantly higher through laparoscopy than through laparotomy after vital dye pericervical injection but intraoperative vital dye pericervical injection is not reliable as part of standard care for predicting lymphatic spread in women with early stage endometrial cancer. J. Surg. Oncol. 2010; 101:408–412. © 2010 Wiley‐Liss, Inc.