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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


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.

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