Introduction/Background This study aimed to define the role of combination of preoperative PET/CT scan and SLN biopsy for detection of nodal metastasis in Endometrial Cancer (EC) patients.
Methodology All patients affected by EC prospectively collected from January 2014 to August 2016 underwent PET/CT scan and SLN mapping using indocyanine green (ICG) as tracer. Patients with suspicious lymph nodes at FDG-PET/CT underwent selective pelvic lymphadenectomy. In case of undetectable SNL, no further lymphadenectomy was performed if PET/CT scan was negative. Basic descriptive statistics were used to describe outcomes.
Results A total of 83 patients were enrolled in the study. PET/CT scan was suggestive of nodal involvement in 15 patients. SLN were detected bilaterally in 78% of patients. Detection rate was influenced by patient’ BMI and learning curve. Five patients were node positive: of these all had hyper metabolic nodes at PET/CT scan, in 1 patient SLN was not detected. Ten out of 15 patients, with suspicious nodal at PET/CT scan, was node negative. After a median follow up of 24 months (range 14–45) all patients are alive. Four patients experienced recurrent disease. No nodal relapse was recorded.
Conclusion Lymphatic mapping with sentinel node biopsy is able to reduce morbidity associated with pelvic lymphadenectomy. Detection rate is strongly improved with learning curve and reduced in morbidly obese patients. PET/CT scan shows high sensitivity for nodal metastasis but moderate specificity and may help to avoid nodal dissection in patients with sentinel node failure.
Disclosure Nothing to disclose.
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