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Feasibility of sentinel lymph node mapping of the ovary: a systematic review
  1. Federica Dell'Orto1,
  2. Pim Laven2,
  3. Martina Delle Marchette1,
  4. Sandrina Lambrechts3,
  5. Roy Kruitwagen2 and
  6. Alessandro Buda1
  1. 1 Department of Obstetrics and Gynecology, Azienda Ospedaliera San Gerardo, Monza, Italy
  2. 2 Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands
  3. 3 GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre + Oncology Centre, Maastricht, The Netherlands
  1. Correspondence to Dr Alessandro Buda, Department of Obstetrics and Gynecology, Azienda Ospedaliera San Gerardo, Monza 20126, Italy; ginoncmonza{at}


Pelvic and para-aortic lymphadenectomy is routinely performed in early ovarian cancer to define the stage of the disease. However, it may be associated with increased blood loss, operative time, and length of hospitalization. The sentinel lymph node technique has been shown to be safe and feasible in vulvar, uterine, and cervical cancer. Data detailing feasibility and outcomes of sentinel lymph node mapping in ovarian cancer are scarce.

To summarize the studies evaluating the feasibility of sentinel lymph node detection from the ovary, examining the technique and detection rate.

A systematic search of the literature was performed using PubMed and Embase from June 1991 to February 2019. Studies describing the sentinel lymph node technique and lymphatic drainage of the ovaries were incorporated in this review. Ten articles were selected, comprising a total of 145 patients. A variety of agents were used, but the primary markers were technetium-99m radiocolloid (Tc-99m), patent blue, or indocyanine green, and the most common injection site was the ovarian ligaments.

The overall sentinel lymph node detection rate was 90.3%.

We propose a standardized technique sentinel lymph node mapping in ovarian cancer, using indocyanine green, or Tc-99m and blue dye as alternative tracers, injected in both the suspensory and the infundibulopelvic ligament of the ovary.

  • ovarian cancer
  • sentinel lymph node

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  • Contributors FD'O and PL contributed equally to the articles research and writing. MDM searched and evaluated data from the literature. SL evaluated data and contributed to the review of the manuscript. RK and AB designed the review study, contributed, analyzed and discussed the data, wrote the draft and reviewed the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.