Study of the sentinel node in endometrial cancer at early stages: preliminary results.
OBJECTIVE
To investigate the applicability of the sentinel lymph node biopsy technique in early stages of endometrial cancer.


METHODS
A prospective study that included consecutive patients with a histological diagnosis of clinical state I endometrial carcinoma was performed. Two doses of 2 mCi (74 MBq) of (99m)Tc-albumin nanocolloid were injected in the uterine cervix, and planar and SPECT-CT images were obtained at one hour, and at 24 hours if no migration of the tracer was observed. Methylene blue dye was also injected into the cervix immediately prior to the surgery. A gamma probe was used during the surgical procedure for sentinel lymph node identification. In all cases, a hysterectomy, double adnexectomy and pelvic lymphadenectomy were performed, carrying out a histological analysis (hematoxylin-eosin) of the sentinel lymph nodes and the lymphadenectomy specimen.


RESULTS
We included 19 patients, with a final diagnoses of endometrioid carcinoma (18 cases) and endometrial stromal sarcoma (1 case). At least one sentinel lymph node was identified in 17 of them (89.5% detection rate). Twenty-nine sentinel lymph nodes were identified during surgery, all of them negative for neoplastic infiltration. No metastatic invasion was found in the pelvic lymphadenectomy specimens as well.


CONCLUSIONS
The sentinel lymph node biopsy technique seems to be a reliable tool in nodal staging of endometrial cancer at early stages, with an acceptable detection rate and high histological correlation. The low prevalence of lymphatic spread in this group of patients and the encouraging results obtained could make the sentinel lymph node an alternative to routine complete lymphadenectomy.
Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Cuidad Real, Spain. mcorderogarcia@gmail.com
J M
JM
Cordero García
C A
CA
López de la Manzanara Cano
A M
AM
García Vicente
R A
RA
Garrido Esteban
A
A
Palomar Muñoz
M P
MP
Talavera Rubio
J P
JP
Pilkington Woll
B
B
González García
A
A
Soriano Castrejón
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D036821:Endometrial Stromal Tumors / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D064847:Multimodal Imaging; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013668:Technetium Tc 99m Aggregated Albumin; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid