Accuracy of robotic sentinel lymph node detection (RSLND) for patients with endometrial cancer (EC)
Autor: | Paul B. Heller, Patrick Hughes, Craig A. Dise, Nana Tchabo, Brian M. Slomovitz, Pranjal H. Desai, Daniel H. Tobias |
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Rok vydání: | 2014 |
Předmět: |
Adult
medicine.medical_specialty Ovariectomy medicine.medical_treatment Sentinel lymph node H&E stain Adenocarcinoma Hysterectomy Pelvis Salpingectomy Carcinosarcoma Robotic Surgical Procedures Adjuvant therapy Humans Medicine Fertility preservation Coloring Agents Aged Retrospective Studies Aged 80 and over Sentinel Lymph Node Biopsy business.industry Endometrial cancer Obstetrics and Gynecology Middle Aged medicine.disease Endometrial Neoplasms Surgery Methylene Blue Dissection Oncology Immunohistochemistry Female Lymphadenectomy Lymph Nodes Radiology business Carcinoma Endometrioid Adenocarcinoma Clear Cell |
Zdroj: | Gynecologic Oncology. 135:196-200 |
ISSN: | 0090-8258 |
DOI: | 10.1016/j.ygyno.2014.08.032 |
Popis: | Lymphadenectomy as a part of the staging for EC patients is controversial. Sentinel lymph node detection has been introduced to determine which patients would benefit from adjuvant therapy and to limit morbidities associated with a full pelvic nodal dissection. The purpose of this study is to evaluate diagnostic accuracy and detection rate of robotic sentinel lymph node detection (RSLND) as a part of the surgical staging for EC.A retrospective database of all patients who underwent intraoperative lymphatic mapping using cervical injection methylene blue followed by RSLND as a part of their procedure was reviewed. Sentinel lymph node (SLN) was initially examined by routine Hematoxylin and Eosin (HE) and ultrastaging by immunohistochemistry (IHC).Between 4/2011 and 6/2013, 120 patients with endometrial cancer underwent RSLND. The median age was 62years (25-87); median BMI was 32 (18-76). Out of 120 patients, only one patient underwent RSLND with fertility preservation; and 119 patients underwent robotic hysterectomy and surgical staging with RSLND. None of the cases was converted to an open procedure. At least 1 SLN was detected in 86% (103/120) of the patients. Bilateral SLNs were detected in 52% (62/120). Positive nodes were identified in 8% (10/120) of the patients. Of those with SLN (+), 50% (5/10) were by ultrastaging (IHC) alone. No patients had positive regional nodes without SLN (+).RSLND using methylene blue cervical injection can identify SLN in most patients with EC. IHC ultrastaging improves the detection of node positive disease when compared to traditional pathological evaluation. |
Databáze: | OpenAIRE |
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