Sentinel lymph node mapping in early stage of endometrial and cervical cancers
Identifieur interne : 001844 ( Main/Exploration ); précédent : 001843; suivant : 001845Sentinel lymph node mapping in early stage of endometrial and cervical cancers
Auteurs : Tajossadat Allameh [Iran] ; Vahidehsadat Hashemi [Iran] ; Fereshteh Mohammadizadeh [Iran] ; Fariba Behnamfar [Iran]Source :
- Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences [ 1735-1995 ] ; 2015.
Abstract
The sentinel lymph node (SLN) is defined as the first chain node in the lymphatic basin that receives primary lymphatic flow. If the SLN is negative for metastatic disease, then other nodes are expected to be disease-free. SLN techniques have been extensively applied in the staging and treatment of many tumors, including melanoma, breast and vulvar cancers. This study aims to evaluate our technique in SLN mapping in early stage endometrial and cervical cancers.
We scheduled a cross-sectional pilot study for patients undergoing staging surgery for endometrial and cervical cancer from November 2012 to February 2014 in Beheshti and Sadoughi Hospitals. Our SLN mapping technique included 1 h preoperative or intraoperative injection of 4 ml of 1% methylene blue dye in the tumor site. At the time of surgery, blue lymph nodes were removed and labeled as SLNs. Then systematic lymph node dissection was completed, and all of the nodes were sent for pathologic examination concerning metastatic involvement. All of the sentinel nodes were first stained with hematoxylin and eosin and examined. Those negative in this study were then stained with immunohistochemistry using anti-keratin antibody. Descriptive statistics, sensitivity, negative predictive values (NPV), false negative (FN) and detection rates were calculated.
Twenty-three patients including 62% endometrial and 38% cervical cancers enrolled in the study. Median of SLN count in the endometrial and cervical cancers was 3 and 2, respectively. Among endometrial and cervical cancers, detection rate of metastatic disease was 80% and 87.5%, respectively. The FN rate for this technique was 0 and the sensitivity and NPV are 100% for both endometrial and cervical cancers.
Considering the lower risk of metastases in early stage of both endometrial and cervical cancers, SLN technique allows for confident and accurate staging of cancer.
Url:
PubMed: 25983771
PubMed Central: 4400713
Affiliations:
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University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Mohammadizadeh, Fereshteh" sort="Mohammadizadeh, Fereshteh" uniqKey="Mohammadizadeh F" first="Fereshteh" last="Mohammadizadeh">Fereshteh Mohammadizadeh</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Behnamfar, Fariba" sort="Behnamfar, Fariba" uniqKey="Behnamfar F" first="Fariba" last="Behnamfar">Fariba Behnamfar</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25983771</idno><idno type="pmc">4400713</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400713</idno><idno type="RBID">PMC:4400713</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">004140</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004140</idno><idno type="wicri:Area/Pmc/Curation">004139</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004139</idno><idno 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Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Hashemi, Vahidehsadat" sort="Hashemi, Vahidehsadat" uniqKey="Hashemi V" first="Vahidehsadat" last="Hashemi">Vahidehsadat Hashemi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Mohammadizadeh, Fereshteh" sort="Mohammadizadeh, Fereshteh" uniqKey="Mohammadizadeh F" first="Fereshteh" last="Mohammadizadeh">Fereshteh Mohammadizadeh</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Behnamfar, Fariba" sort="Behnamfar, Fariba" uniqKey="Behnamfar F" first="Fariba" last="Behnamfar">Fariba Behnamfar</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences</title><idno type="ISSN">1735-1995</idno><idno type="eISSN">1735-7136</idno><imprint><date when="2015">2015</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>The sentinel lymph node (SLN) is defined as the first chain node in the lymphatic basin that receives primary lymphatic flow. If the SLN is negative for metastatic disease, then other nodes are expected to be disease-free. SLN techniques have been extensively applied in the staging and treatment of many tumors, including melanoma, breast and vulvar cancers. This study aims to evaluate our technique in SLN mapping in early stage endometrial and cervical cancers.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>We scheduled a cross-sectional pilot study for patients undergoing staging surgery for endometrial and cervical cancer from November 2012 to February 2014 in Beheshti and Sadoughi Hospitals. Our SLN mapping technique included 1 h preoperative or intraoperative injection of 4 ml of 1% methylene blue dye in the tumor site. At the time of surgery, blue lymph nodes were removed and labeled as SLNs. Then systematic lymph node dissection was completed, and all of the nodes were sent for pathologic examination concerning metastatic involvement. All of the sentinel nodes were first stained with hematoxylin and eosin and examined. Those negative in this study were then stained with immunohistochemistry using anti-keratin antibody. Descriptive statistics, sensitivity, negative predictive values (NPV), false negative (FN) and detection rates were calculated.</p></sec><sec id="st3"><title>Results:</title><p>Twenty-three patients including 62% endometrial and 38% cervical cancers enrolled in the study. Median of SLN count in the endometrial and cervical cancers was 3 and 2, respectively. Among endometrial and cervical cancers, detection rate of metastatic disease was 80% and 87.5%, respectively. The FN rate for this technique was 0 and the sensitivity and NPV are 100% for both endometrial and cervical cancers.</p></sec><sec id="st4"><title>Conclusion:</title><p>Considering the lower risk of metastases in early stage of both endometrial and cervical cancers, SLN technique allows for confident and accurate staging of cancer.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Perrone, Am" uniqKey="Perrone A">AM Perrone</name></author><author><name sortKey="Casadio, P" uniqKey="Casadio P">P Casadio</name></author><author><name sortKey="Formelli, G" uniqKey="Formelli G">G Formelli</name></author><author><name sortKey="Levorato, M" uniqKey="Levorato M">M Levorato</name></author><author><name sortKey="Ghi, T" uniqKey="Ghi T">T Ghi</name></author><author><name sortKey="Costa, S" uniqKey="Costa S">S Costa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gortzak Uzan, L" uniqKey="Gortzak Uzan 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Rob</name></author><author><name sortKey="Strnad, P" uniqKey="Strnad P">P Strnad</name></author><author><name sortKey="Robova, H" uniqKey="Robova H">H Robova</name></author><author><name sortKey="Charvat, M" uniqKey="Charvat M">M Charvat</name></author><author><name sortKey="Pluta, M" uniqKey="Pluta M">M Pluta</name></author><author><name sortKey="Schlegerova, D" uniqKey="Schlegerova D">D Schlegerova</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cibula, D" uniqKey="Cibula D">D Cibula</name></author><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kushner, Dm" uniqKey="Kushner D">DM Kushner</name></author><author><name sortKey="Connor, Jp" uniqKey="Connor J">JP Connor</name></author><author><name sortKey="Wilson, Ma" uniqKey="Wilson M">MA Wilson</name></author><author><name sortKey="Hafez, Gr" uniqKey="Hafez G">GR Hafez</name></author><author><name sortKey="Chappell, Rj" uniqKey="Chappell R">RJ Chappell</name></author><author><name sortKey="Stewart, Sl" uniqKey="Stewart S">SL Stewart</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Iran</li></country></list><tree><country name="Iran"><noRegion><name sortKey="Allameh, Tajossadat" sort="Allameh, Tajossadat" uniqKey="Allameh T" first="Tajossadat" last="Allameh">Tajossadat Allameh</name></noRegion><name sortKey="Behnamfar, Fariba" sort="Behnamfar, Fariba" uniqKey="Behnamfar F" first="Fariba" last="Behnamfar">Fariba Behnamfar</name><name sortKey="Hashemi, Vahidehsadat" sort="Hashemi, Vahidehsadat" uniqKey="Hashemi V" first="Vahidehsadat" last="Hashemi">Vahidehsadat Hashemi</name><name sortKey="Mohammadizadeh, Fereshteh" sort="Mohammadizadeh, Fereshteh" uniqKey="Mohammadizadeh F" first="Fereshteh" last="Mohammadizadeh">Fereshteh Mohammadizadeh</name></country></tree></affiliations></record>Pour 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