Article Text

Download PDFPDF
EP603 Three types of sentinel lymph nodes and three routes of lymph drainage for endometrial cancer
  1. O Postupalenko and
  2. K Kharchenko
  1. Department of Minimally Invasive Surgery, Kyiv City Clinical Oncology Centre, Kyiv, Ukraine

Abstract

Introduction/Background Identification of sentinel lymph node (SLN) is an alternative procedure that allows to individualize surgical staging of lymph nodes (LN).

Methodology Prospective non-randomized trial was performed to investigate the peculiarities of SLN mapping for endometrial cancer with the usage of methylene blue dye.

Results All cases of SLN mapping (n=89) were analysed according to the spread of contrast by lymphatic pathways and peculiarities of SLN. In all cases at least one lymph-drainage pathway was identified, both-sided pathways were identified in 78 cases (83,9%), right- an left-sided - in 86 (92,5%) and 85 (91,4%) cases respectively. Infundibulo-pelvic pathway was identified in 17 patients (18,3%), upper and lower paracervical pathway in 67 (72%) and 37 (39,4%) cases respectively. It was mentioned that there are three types of SLN. Type I (‘classical’ SLN) - contrasted afferent lymph vessel and LN. Type II - contrasted afferent lymph vessel that lead to LN which is either not contrasted (contrast breaks off at the confluence) or contain dot blotches of blue dye (‘marble’ SLN). Type III - any suspicious LN. All of aforementioned lymph nodes require a biopsy. Pelvic LN dissection (referent method) were completed in 41 cases (46%), among them type I SLN was in 24 cases (58,5%), type ІІ - in 3 (7,3%), type ІІІ - in 11 (26,8%), SLN was not identified in 3 patients (7,3%). LN metastases were verified in 10 patients (10,8%). Five cases of type I SLN (20,8%) had LN metastases. All three cases of type II SLN were metastatic. Two cases of type III SLN (18,2%) contain LN metastases.

Conclusion Usage of the concept of three types of SLN and three routs of lymph drainage may be a perspective method for improvement of endometrial cancer treatment results. Further studies with larger number of patients are needed to prove this hypothesis.

Disclosure Nothing to disclose.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.