Intraoperative sentinel lymph node detection by vital dye through laparoscopy or laparotomy in early endometrial cancer.
OBJECTIVE
Recent studies reported the feasibility of intraoperative lymphatic mapping in women with endometrial cancer but none of these studies compared the sentinel lymph nodes (SLNs) detection rates obtainable through laparoscopy or laparotomy. The purpose of this study was to address this issue.


METHODS
Thirty-four patients with clinical stage I-II endometrial cancer were enrolled in this prospective comparative trial. Four milliliters of Patent Blue Violet were injected into the cervix after the induction of general anesthesia. The assessment of SLNs was done in 17 patients through laparoscopy and in 17 patients through laparotomy as first step of systematic pelvic lymphadenectomy. Both SLNs and non-SLNs were evaluated for micrometastases.


RESULTS
The SLNs detection rate was significantly higher (82%) for laparoscopy than for laparotomy (41%; P = 0.008). Pelvic lymph node metastases were present in 6 out of 34 patients (18%) but only 3 (50%) of these patients were correctly identified.


CONCLUSIONS
SLNs detection rate is significantly higher through laparoscopy than through laparotomy after vital dye pericervical injection but intraoperative vital dye pericervical injection is not reliable as part of standard care for predicting lymphatic spread in women with early stage endometrial cancer.
Mais
Valerio
V
Division of Gynecology, Department of Surgery, Maternal-Fetal Medicine, and Imaging, University of Cagliari Medical School, Cagliari, Italy.
Peiretti
Michele
M
Gargiulo
Tigellio
T
Parodo
Giuseppina
G
Cirronis
Maria Giuseppina
MG
Melis
Gian Benedetto
GB
D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008875:Middle Aged; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D012394:Rosaniline Dyes; C008769:sulfan blue