A pilot study of sentinel lymph nodes identification in patients with endometrial cancer.

PURPOSE: The purpose of this study was to investigate the feasibility of sentinel lymph node (SLN) identification in patients with endometrial cancer.

METHODS

Twenty patients with endometrial cancer undergoing hysterectomy and lymphadenectomy were included in the study. At laparotomy, methylene blue dye was injected into the subserosal myometrium of corpus uteri at multiple sites. Dye uptake into lymphatic channels was observed and blue nodes were identified as SLNs. The SLNs were biopsied before lymphadenectomy performed. The samples of SLNs and non-SLNs were recorded separately and correlated with the final pathological results.

RESULTS

Dye uptake into lymphatic channels was seen in all 20 cases. Among them, SLN was identified in 15 (75%) cases. A total of 71 SLNs with a mean number of 4.7 SLN (range, 1-10) were identified from all pelvic sites. The most frequent locations of SLNs included obturator in 29 (41%), interiliac in 16 (26%). No dye-containing paraaortic nodes were found. Two patients (10%) had nodal metastases, and they all had at least one SLN found to be positive. No adverse reactions or injures were attributed to the study.

CONCLUSIONS

This study shows the feasibility and safety of SLN identification with blue dye in patients with endometrial cancer undergoing staging surgery. The approach might provide an alternative to limit the extent of nodal sampling.