title: Value of Sentinel Lymph Node (SLN) Mapping and Biopsy using Combined Intracervical Radiotracers and Blue Dye Injections for Endometrial Cancer
abstract: Background: Lymphadenectomy, as part of the initial surgical staging of patients with endometrial carcinoma,
  remains a controversial topic in gynecologic oncology. Sentinel lymph node (SLN) mapping has become a well-accepted
  procedure for melanomas and breast cancer; a number of investigators have begun to explore the utility and accuracy
  of this technique with regard to endometrial cancer. Aim: This study was conducted to evaluate SLN mapping of
  early stage endometrial cancer with blue dye in conjunction with a radioactive tracer. Subjects and methods: In this
  prospective cross-sectional study, patients with stage I and II endometrial cancer who were candidates for systemic
  lymph node dissection during surgery were enrolled, some underwent lymph node mapping and SLN biopsy using
  combined intra cervical radiotracer and blue dye injections and some applying only an intra cervical radiotracer. SLNs
  and other lymph nodes were sent for pathological assessment. Sensitivity, specificity, the positive predictive value, and
  the negative predictive value were calculated as predictive values for the radiotracer and blue dye. Results: Pre-operative
  lymph node mapping showed SLN in 29 out of 30 patients. Intra operations in 29/30 patients, SLNs were harvested by
  gamma probe; in 13 out of 19 patients SLNs were detected by blue dye. The median number of SLNs per patient was
  3 and the total number of SLNs detected was 81. Four patients had positive pelvic lymph nodes. All of the positive
  nodes were SLNs. Using this technique (radiotracer and blue dye) an overall detection rate of 96.7%, an NPV of 100%,
  a sensitivity of 100% and a specificity of 3.85% were achieved. Conclusion: Results of SLN research for endometrial
  cancer are promising and make feasible the possibility of avoiding unnecessary aggressive surgical procedures in near
  future by advances in SLN mapping.
authors.affiliation: Preventative Gynecology Research Center, Shahid Beheshti university of Medical Sciences, Tehran, Iran. Email: moridi59@
  gmail.com
authors.forename: Farah
authors.initials: F
authors.lastname: Farzaneh
authors.forename: Atefeh
authors.initials: A
authors.lastname: Moridi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Azizmohammadi
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Ansari J
authors.forename: Maryam Sadat
authors.initials: MS
authors.lastname: Hosseini
authors.forename: Maliheh
authors.initials: M
authors.lastname: Arab
authors.forename: Tahereh
authors.initials: T
authors.lastname: Ashrafganjoei
authors.forename: Mina
authors.initials: M
authors.lastname: Mazaheri
keywords: Sentinel lymph node; radiotracer; blue dye; cervical injection; endometrial cancer