The evaluation of sentinel node in early stage endometrial cancer

Doctoral Dissertation uoadl:2191155 235 Read counter

Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences
Deposit date:
Biliatis Ioannis
Dissertation committee:
Αλεξανδρος Ροδολάκης, Καθηγητης, Ιατρική, ΕΚΠΑ
Άρης Αντσακλής, Ομότιμος Καθηγητης, Ιατρική, ΕΚΠΑ
Δημήτριος Λουτράδης, Καθηγητης, Ιατρική, ΕΚΠΑ
Αθανάσιος Πρωτόπαπας, Αν Καθηγητής, Ιατρική, ΕΚΠΑ
Σταύρος Αθανασίου, Αν Καθηγητης, Ιατρική, ΕΚΠΑ
Δημήτριος Χαιδόπουλος, Επικ Καθηγητης, Ιατρική, ΕΚΠΑ
Θεόδωρος Πανοσκάλτσης, Επικ Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Ανίχνευση και αξιολόγηση του φρουρού λεμφαδένα σε καρκίνο ενδομητρίου πρώιμου σταδίου
Translated title:
The evaluation of sentinel node in early stage endometrial cancer
Objective: To define the detection rate, sensitivity and negative predictive value (NPV) of the sentinel node technique in patients with endometrial cancer.
Methods: Patients with endometrial cancer after informed consent underwent subserosal injection of blue dye during hysterectomy in a tertiary gynae/oncology department between 2010 and 2014. The procedure was performed in all cases by the same team including 2 Gynae/Oncologist Consultants and one trainee. All relevant perioperative clinicopathological characteristics of the population were recorded prospectively. The identified sentinel nodes were removed separately and a completion bilateral pelvic lymphadenectomy followed in all cases. Simple statistics were used to calculate the sensitivity and NPV of the method on per patient basis.
Results: Fifty-four patients were included in this study. At least one sentinel node was mapped in 46 patients yielding a detection rate of 85.2%. Bilateral detection of sentinel nodes was accomplished in only 31 patients (57.4%). The mean number of sentinel nodes was 2.6 per patient and the commonest site of identification was the external iliac artery and vein area (66%). Six patients (11%) had a positive lymph node and in five of them this was the sentinel one yielding a sensitivity of 83.3% and a NPV of 97.5%. The overall detection rate improved significantly after the first 15 cases, however this was not the case for the bilateral detection rate.
Conclusion: Our study is in accordance with previous studies of sentinel node in endometrial cancer and further demonstrates and enhances the confidence in the technique. In the current era of an ongoing debate on whether a systematic lymphadenectomy in patients with endometrial cancer is still necessary, we believe that the sentinel node is an acceptable alternative and should be applied routinely in tertiary centres following a strict algorithm.
Main subject category:
Health Sciences
Endometrial cancer, Sentinel node, Blue dye, Detection rate, Sensitivity
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