Ovarian sentinel node: is it feasible?

OBJECTIVE

To examine whether the intraoperative combined injection technique is feasible in locating the sentinel node(s) of the ovary.

METHODS/MATERIALS: In 16 patients with high-risk uterine cancer and normal postmenopausal ovaries, technetium isotope and blue dye were injected in the right or left ovary during laparotomy, respectively. During the operation, the pelvic and para-aortic lymphatic areas were searched, and the number, method of detection, and location(s) of the hot and/or blue node(s) were recorded.

RESULTS

One to 3 sentinel nodes per patient were identified in all but 1 patient (15 of 16, 94%). The sentinel nodes (n = 30) were all located in the para-aortic area. The sentinel nodes of the left ovary were mainly (9 of 14, 64%) located above the inferior mesenteric artery level, as the most sentinel nodes of the right ovary (15 of 16, 94%) were found below the inferior mesenteric artery level (P = 0.001). There were no contralateral or bilateral sentinel nodes.

CONCLUSIONS

The combined intraoperative injection technique with radioisotope and blue dye is fast enough to identify the ovarian sentinel node(s). The stained nodes were consistently located on a certain lymphatic area. The sentinel node concept for the early ovarian cancer deserves more attention.