title: Accuracy of Sentinel Node in Detecting Lymph Node Metastasis in Primary Endometrial Carcinoma.
abstract: BACKGROUND
  Endometrial carcinoma is the most common gynecological cancer and its treatment is still controversial, especially in its early stages. There are conflicting data about the efficacy of retroperitoneal lymphadenectomy during abdominal hysterectomy and bilateral salpingoophrectomy treatment. Lymphadenectomy carries a risk of severe complications, especially in women with co-morbidities. Selective lymphadenectomy has been widely employed for staging evaluation of endometrial carcinoma because it is simple and seems to provide reliable data regarding nodal metastasis. This study was designed to evaluate accuracy of sentinel node sampling in detecting lymph node metastasis in primary endometrial carcinoma during staging laparotomy.
  
  
  METHODS
  Ninety-three women with endometrial carcinoma at high-risk for nodal metastasis were studied. During laparotomy, methylene blue dye was injected into sub-serosal myometrium, then retroperitoneal spaces were opened and blue lymph nodes within pelvic and para-aortic regions were removed as separate specimens for histopathological examination (sentinel lymph nodes=SLNs). Hysterectomy and selective lymphadenectomy then performed for all women included in this study.
  
  
  RESULTS
  Deposition of methylene dye into at least one lymph node was observed in 73.1% (68/93) of studied cases. 18.3% (17/93) of studied women had positive lymph node metastasis and 94.1% (16/17) of them had positive metastasis in SLNs. In this study, SNLs had 94.4% sensitivity and 100% specificity in prediction of lymph node metastasis. Mean number of lymph nodes removed from each case decreased when SLNs biopsy were taken.
  
  
  CONCLUSIONS
  SLNs are the key lymph nodes in endometrial tumor metastasis and their involvement could be an indicator for whether or not complete systematic lymphadenectomy is needed during staging laparotomy.
authors.affiliation: Professor of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt, and Ahmadi Kuwait Oil Company (KOC) Hospital, Kuwait E-mail : dr.ibrahimanwar@gmail.com.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Farghali
authors.forename: Ihab S
authors.initials: IS
authors.lastname: Allam
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: Abdelazim
authors.forename: Osama S
authors.initials: OS
authors.lastname: El-Kady
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: Rashed
authors.forename: Waheed Y
authors.initials: WY
authors.lastname: Gareer
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Sweed
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D004396:Coloring Agents; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008751:Methylene Blue; D008875:Middle Aged; D010388:Pelvis; D012187:Retroperitoneal Space; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy
chemical_list: D004396:Coloring Agents; D008751:Methylene Blue