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Sentinel lymph node in endometrial cancer
  1. L.A.F Lopes*,
  2. S. M Nicolau,
  3. F. F Baracat*,
  4. E. C Baracat,
  5. W. J Gonçalves,
  6. H.V.B Santos,
  7. R. G Lopes* and
  8. U. G Lippi*
  1. * Department of Obstetrics and Gynecology, Hospital do Servidor Público Estadual de São Paulo—Francisco Morato Oliveira, São Paulo, SP, Brazil;
  2. Department of Gynecology, Federal University of São Paulo, São Paulo, SP, Brazil; and
  3. Department of Pathology, Hospital do Servidor Público Estadual de São Paulo—Francisco Morato Oliveira, São Paulo, SP, Brazil
  1. Address correspondence and reprint requests to: Luiz Agusto Freire Lopes, MD, Department of Obstetrics and Gynecology, Hospital do Servidor Público Estadual de São Paulo—Francisco Morato Oliveira, Rua Pedro de Toledo 1800, 4th Floor, São Paulo, SP, Brazil 04039-032. Email: luizfreire1947{at}yahoo.com.br

Abstract

The aim of this study was to evaluate the possibility of identifying the sentinel lymph node and involvement of neoplastic cells in patients with endometrial carcinoma limited to the uterus, and also its correlation with the conditions of other pelvic and para-aortic lymph nodes. Forty patients with endometrial carcinoma, clinical staging I and II, were submitted to complete surgical staging through laparotomy, as recommended by FIGO in 1988. The sentinel node was investigated using patent blue dye in the myometrial subserosa. The sentinel node was excised and submitted to frozen section examination of specimen, stained with hematoxylin and eosin (H&E). Afterward, selective bilateral para-aortic and pelvic lymphadenectomy, total hysterectomy with bilateral salpingo-oophorectomy were performed. The lymph nodes excised were examined by means of paraffin-embedded slices stained with H&E and of imunohistochemistry with antikeratin antibody AE1/AE3. The sentinel lymph node was identified in 77.5% of patients (31/40), and 16.1% (5/31) presented neoplastic involvement in the node. In 25 cases of negative sentinel node, 96% (24/25) had no neoplastic involvement, and 4% (1/25) had other lymph node affected (false negative). In nine cases with no sentinel node identified, 55.5% (5/9) had lymph node involvement. The results of this study allow us to conclude that it is possible to identify the sentinel node using the methods described, and the pathologic examination significantly represents the same conditions of other pelvic and para-aortic lymph nodes.

  • endometrial carcinoma
  • lymph node excision
  • sentinel lymph node

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