title: Lymphatic mapping and sentinel node biopsy in women with high-risk endometrial cancer.
abstract: OBJECTIVE
  To evaluate fundal injection of blue dye and radiocolloid for lymphatic mapping and sentinel node identification in women with high-risk endometrial cancer.
  
  
  METHODS
  At laparotomy, 18 women with high-risk endometrial cancer had isosulfan blue and technitium-99 radiocolloid injected into the uterine fundus subserosally. Sentinel nodes were then identified either by direct observation of blue dye, by radioactive counts using a handheld gamma counter, or by a combination of both methods. The number and location of sentinel node(s) were recorded and compared with the final lymph node specimens after hysterectomy and selective lymphadenectomy.
  
  
  RESULTS
  A sentinel node was identified in only 8 (45%) of the cases. Four patients had sentinel nodes only in the pelvis, 2 had sentinel nodes in the pelvis and above the bifurcation of the aorta, and 2 patients had sentinel nodes above the bifurcation of the aorta only. Seven (88%) patients had unilateral drainage of dye and the radiocolloid; the other patient had bilateral drainage. No patients had metastatic disease to sentinel or nonsentinel lymph nodes.
  
  
  CONCLUSIONS
  Subserosal fundal injection of blue dye and the radiocolloid is a poor technique for identifying sentinel lymph nodes in patients with high-risk endometrial cancer.
authors.affiliation: Department of Gynecologic Oncology, CPB6.3244, Unit 1362, The University of Texas M. D. Anderson Cancer Center, 1155 Herman Pressler, TX 77030, USA. mfrumovitz@mdanderson.org
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.forename: Russell R
authors.initials: RR
authors.lastname: Broaddus
authors.forename: Robert L
authors.initials: RL
authors.lastname: Coleman
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: David M
authors.initials: DM
authors.lastname: Gershenson
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Burke
authors.forename: Charles F
authors.initials: CF
authors.lastname: Levenback
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D017556:Technetium Compounds
chemical_list: D017556:Technetium Compounds