Value of Sentinel Lymph Node (SLN) Mapping and Biopsy using Combined Intracervical Radiotracers and Blue Dye Injections for Endometrial Cancer
Identifieur interne : 000033 ( Main/Exploration ); précédent : 000032; suivant : 000034Value of Sentinel Lymph Node (SLN) Mapping and Biopsy using Combined Intracervical Radiotracers and Blue Dye Injections for Endometrial Cancer
Auteurs : Farah Farzaneh ; Atefeh Moridi ; Zahra Azizmohammadi ; Mojtaba Ansari J ; Maryam Sadat Hosseini ; Maliheh Arab ; Tahereh Ashrafganjoei ; Mina MazaheriSource :
- Asian Pacific Journal of Cancer Prevention : APJCP [ 1513-7368 ] ; 2017.
Abstract
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.
This study was conducted to evaluate SLN mapping of early stage endometrial cancer with blue dye in conjunction with a radioactive tracer.
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.
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.
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.
Url:
DOI: 10.22034/APJCP.2017.18.2.431
PubMed: 28345826
PubMed Central: 5454739
Affiliations:
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type="wicri:Area/Main/Exploration">000033</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Value of Sentinel Lymph Node (SLN) Mapping and Biopsy using Combined Intracervical Radiotracers and Blue Dye Injections for Endometrial Cancer</title><author><name sortKey="Farzaneh, Farah" sort="Farzaneh, Farah" uniqKey="Farzaneh F" first="Farah" last="Farzaneh">Farah Farzaneh</name><affiliation><nlm:aff id="aff1"><italic>Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="Moridi, Atefeh" sort="Moridi, Atefeh" uniqKey="Moridi A" first="Atefeh" last="Moridi">Atefeh Moridi</name><affiliation><nlm:aff id="aff1"><italic>Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="Azizmohammadi, Zahra" sort="Azizmohammadi, Zahra" uniqKey="Azizmohammadi Z" first="Zahra" last="Azizmohammadi">Zahra Azizmohammadi</name><affiliation><nlm:aff id="aff2"><italic>Nuclear Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="J, Mojtaba Ansari" sort="J, Mojtaba Ansari" uniqKey="J M" first="Mojtaba Ansari" last="J">Mojtaba Ansari J</name><affiliation><nlm:aff id="aff2"><italic>Nuclear Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="Hosseini, Maryam Sadat" sort="Hosseini, Maryam Sadat" uniqKey="Hosseini M" first="Maryam Sadat" last="Hosseini">Maryam Sadat Hosseini</name><affiliation><nlm:aff id="aff1"><italic>Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="Arab, Maliheh" sort="Arab, Maliheh" uniqKey="Arab M" first="Maliheh" last="Arab">Maliheh Arab</name><affiliation><nlm:aff id="aff1"><italic>Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="Ashrafganjoei, Tahereh" sort="Ashrafganjoei, Tahereh" uniqKey="Ashrafganjoei T" first="Tahereh" last="Ashrafganjoei">Tahereh Ashrafganjoei</name><affiliation><nlm:aff id="aff1"><italic>Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author><author><name sortKey="Mazaheri, Mina" sort="Mazaheri, Mina" uniqKey="Mazaheri M" first="Mina" last="Mazaheri">Mina Mazaheri</name><affiliation><nlm:aff id="aff3"><italic>Radiology Technologist, Nuclear Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran</italic></nlm:aff></affiliation></author></analytic><series><title level="j">Asian Pacific Journal of Cancer Prevention : APJCP</title><idno type="ISSN">1513-7368</idno><idno type="eISSN">2476-762X</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>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.</p></sec><sec id="st2"><title>Aim:</title><p>This study was conducted to evaluate SLN mapping of early stage endometrial cancer with blue dye in conjunction with a radioactive tracer.</p></sec><sec id="st3"><title>Subjects and methods:</title><p>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.</p></sec><sec id="st4"><title>Results:</title><p>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.</p></sec><sec id="st5"><title>Conclusion:</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author><author><name sortKey="Gomez, Jd" uniqKey="Gomez J">JD Gomez</name></author><author><name sortKey="Alektiar, Km" uniqKey="Alektiar K">KM Alektiar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Allameh, T" uniqKey="Allameh T">T Allameh</name></author><author><name sortKey="Hashemi, V" uniqKey="Hashemi V">V Hashemi</name></author><author><name sortKey="Mohammadizadeh, F" 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sort="Farzaneh, Farah" uniqKey="Farzaneh F" first="Farah" last="Farzaneh">Farah Farzaneh</name><name sortKey="Hosseini, Maryam Sadat" sort="Hosseini, Maryam Sadat" uniqKey="Hosseini M" first="Maryam Sadat" last="Hosseini">Maryam Sadat Hosseini</name><name sortKey="J, Mojtaba Ansari" sort="J, Mojtaba Ansari" uniqKey="J M" first="Mojtaba Ansari" last="J">Mojtaba Ansari J</name><name sortKey="Mazaheri, Mina" sort="Mazaheri, Mina" uniqKey="Mazaheri M" first="Mina" last="Mazaheri">Mina Mazaheri</name><name sortKey="Moridi, Atefeh" sort="Moridi, Atefeh" uniqKey="Moridi A" first="Atefeh" last="Moridi">Atefeh Moridi</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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