Lymphatic mapping and sentinel node biopsy in women with high-risk endometrial cancer.
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.
Frumovitz
Michael
M
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
Bodurka
Diane C
DC
Broaddus
Russell R
RR
Coleman
Robert L
RL
Sood
Anil K
AK
Gershenson
David M
DM
Burke
Thomas W
TW
Levenback
Charles F
CF
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
D017556:Technetium Compounds