Cervical and hysteroscopic injection for identification of sentinel lymph node in endometrial cancer.
OBJECTIVE
The aims of our study were to evaluate the possibility of identifying the sentinel lymph node (SLN) in patients with endometrial cancer (EC) and to directly compare two injection techniques, cervical and hysteroscopic injection.


METHODS
Fifty-four patients with endometrial carcinoma, clinical stages I and II, were submitted to complete surgical staging through laparoscopy, as recommended by FIGO in 1988. For the mapping procedure the patients were divided into two groups of injection: the cervical injection group and hysteroscopic injection group. Technetium (Tc) 99m radiocolloid was used as tracer.


RESULTS
Intraoperative detection rate of SLN was 70% in cervical group and 65% in the hysteroscopic group (p=n.s.). In the cervical group, all patients had SLN in the pelvis only and the mean SLN removed was 18 (range 2-26). In the hysteroscopic group, all patients had SNLs in the pelvis and two patients had SLN both in the pelvis and above the bifurcation of the aorta. Mean pelvic SLN removed was 20 (range 8-42).


CONCLUSIONS
Our data shows that it is possible to identify the SLN in tumours of the endometrium. Both cervical and hysteroscopic techniques are feasible but the hysteroscopic procedure might represent the only method able to highlight the complete lymphatic drainage of the uterus as suggested by the presence of paraaortic positive SLN only in this group.
Perrone
Anna Myriam
AM
Centre for Sexual Health, S. Orsola Hospital, University of Bologna, Bologna, Italy. amperrone@libero.it
Casadio
Paolo
P
Formelli
Guido
G
Levorato
Maurizio
M
Ghi
Tullio
T
Costa
Silvano
S
Meriggiola
Maria Cristina
MC
Pelusi
Giuseppe
G
D000368:Aged; D002584:Cervix Uteri; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin / Q000008:administration & dosage*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid