Cervical versus endometrial injection for sentinel lymph node detection in endometrial cancer: a randomized clinical trial
| Autor: | İzzet Yücesoy, Sener Gezer, Çiğdem Vural, Seda Duman Öztürk, Turkay Hekimsoy, Aydın Çorakçi, Serkan Isgoren |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Phytic Acid medicine.medical_treatment Sentinel lymph node H&E stain Endometrium Pelvis 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Lymph node Aorta Aged Neoplasm Staging 030219 obstetrics & reproductive medicine Sentinel Lymph Node Biopsy business.industry Endometrial cancer Obstetrics and Gynecology Organotechnetium Compounds Middle Aged medicine.disease Endometrial Neoplasms medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female Lymphadenectomy Lymph Nodes Radiology Lymph Radiopharmaceuticals Sentinel Lymph Node business Lymphoscintigraphy Gamma probe |
| Zdroj: | International Journal of Gynecologic Cancer. 30:325-331 |
| ISSN: | 1525-1438 1048-891X |
| DOI: | 10.1136/ijgc-2019-000860 |
| Popis: | ObjectiveTo evaluate the relationship between pelvic/para-aortic sentinel lymph node status and two different injection sites of 99m-technetium (99mTc)-labeled phytate in patients with endometrial cancer.MethodsThis was a randomized controlled trial involving 81 patients with endometrial cancer. In the cervical group (n=40), injections of 99mTc were performed at the 3 and 9 o’clock positions of the uterine cervix. In the endometrial group (n=41), 99mTc was injected into the fundal endometrium using a transcervical catheter. Sentinel lymph nodes were detected through pre-operative lymphoscintigraphy and intra-operatively using a handheld gamma probe. All patients underwent complete pelvic and para-aortic lymphadenectomy procedures. Pathologic ultra-staging was performed with immunostaining for cytokeratin in sentinel lymph nodes after routine hematoxylin and eosin histological examinations. The primary endpoint was the estimation of detection rates, sensitivity, false-negative rates, negative predictive value, and analysis of the distribution of pelvic and para-aortic sentinel lymph nodes.ResultsThe rate of detection of at least one sentinel lymph node, sensitivity, and the negative predictive value was 80%, 66.6%, 96.6% for the cervical group and 85%, 66.6%, 96.9% for the endometrial group, respectively. False-negative sentinel lymph nodes were detected in one patient from each group . There was no significant difference between the groups in terms of total sentinel lymph node count, sentinel pelvic lymph node count, and pelvic bilaterality, but the para-aortic sentinel lymph node count was significantly higher in the endometrial group (pConclusionTranscervical endometrial tracer injection in endometrial cancer revealed similar pelvic but significantly higher para-aortic sentinel lymph node detection. |
| Databáze: | OpenAIRE |
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