Laparoscopic sentinel node mapping using combined detection for endometrial cancer: a study of 33 cases—is it a promising technique?

Barranger, Emmanuel; Delpech, Yann; Coutant, Charles; Dubernard, Gil; Uzan, Serge; Darai, Emile

doi:10.1016/j.amjsurg.2007.10.021

« Previous Next »The American Journal of Surgery
Volume 197, Issue 1 , Pages 1-7, January 2009

Laparoscopic sentinel node mapping using combined detection for endometrial cancer: a study of 33 cases—is it a promising technique?

Emmanuel Barranger, M.D.
- Department of Gynecologic and Breast cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France
- Department of Gynecology and Obstetrics, Hôpital Lariboisière, Paris, France
- Corresponding author. Tel.: +33-1-49-95-84-09; fax: +33-1-49-95-84-03
Yann Delpech, M.D.
- Department of Gynecologic and Breast cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France
Charles Coutant, M.D.
- Department of Gynecologic and Breast cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France
Gil Dubernard, M.D.
- Department of Gynecology and Obstetrics, Hôpital Lariboisière, Paris, France
Serge Uzan, M.D.
- Department of Gynecologic and Breast cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France
Emile Darai, M.D., Ph.D.
- Department of Gynecologic and Breast cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France

Received 8 May 2007; received in revised form 22 October 2007 published online 16 June 2008.

Abstract

Background

To evaluate the feasibility of a laparoscopic sentinel node (SN) procedure based on combined method in patients with endometrial cancer.

Methods

Thirty-three patients (median age 66.1 years) with endometrial cancer of apparent stage I or stage II underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically. After the SN procedure, all the patients underwent laparoscopic bilateral pelvic lymphadenectomy.

Results

SNs were identified in only 27 patients (81.8%). The mean number of SNs was 2.5 per patient (range 1–5). Only 18 patients (54.5%) had an identified bilateral SN. The most common site of the SNs was the medial external iliac region (67.6%). Fourteen SNs (19.7%) from 8 patients (24.2%) were found to be metastatic at the final histological assessment. No false-negative SN results were observed.

Conclusions

A SN procedure based on a combined detection and laparoscopic approach is feasible in patients with early endometrial cancer. However, because of a low rate of bilateral and global SN detections and problems of injection site using pericervical injection of radiocolloid and blue dye, alternative methods should be explored. Pericervical injections should be avoided.

Keywords: Sentinel node, Laparoscopy, Patent blue, Radiocolloid, Endometrial cancer