Lymphatic mapping and sentinel node biopsy in women with high-risk endometrial cancer |
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Authors: | Frumovitz Michael Bodurka Diane C Broaddus Russell R Coleman Robert L Sood Anil K Gershenson David M Burke Thomas W Levenback Charles F |
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Institution: | Department of Gynecologic Oncology, CPB6.3244, Unit 1362, The University of Texas M. D. Anderson Cancer Center, 1155 Herman Pressler, TX 77030, USA. mfrumovitz@mdanderson.org |
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Abstract: | OBJECTIVE: To evaluate fundal injection of blue dye and radiocolloid for lymphatic mapping and sentinel node identification in women with high-risk endometrial cancer. METHODS: At laparotomy, 18 women with high-risk endometrial cancer had isosulfan blue and technitium-99 radiocolloid injected into the uterine fundus subserosally. Sentinel nodes were then identified either by direct observation of blue dye, by radioactive counts using a handheld gamma counter, or by a combination of both methods. The number and location of sentinel node(s) were recorded and compared with the final lymph node specimens after hysterectomy and selective lymphadenectomy. RESULTS: A sentinel node was identified in only 8 (45%) of the cases. Four patients had sentinel nodes only in the pelvis, 2 had sentinel nodes in the pelvis and above the bifurcation of the aorta, and 2 patients had sentinel nodes above the bifurcation of the aorta only. Seven (88%) patients had unilateral drainage of dye and the radiocolloid; the other patient had bilateral drainage. No patients had metastatic disease to sentinel or nonsentinel lymph nodes. CONCLUSIONS: Subserosal fundal injection of blue dye and the radiocolloid is a poor technique for identifying sentinel lymph nodes in patients with high-risk endometrial cancer. |
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