Article Text
Abstract
Introduction/Background Endometrial cancer is the sixth common female cancer and second common female genital cancer in India. The standard surgical treatment comprise hysterectomy with pelvic and paraortic lymph node dissection.Sentinel lymph node mapping helps to avoid overstaging and associated morbidity.
Methodology Prospective study from May 2017 to September 2018. 30 patients diagnosed with endometrial cancer were included in the study. All patients had preoperative MRI as a part of institute protocol.MRI helped to select out patients without nodal enlargement. Informed consent was taken from all patients.Intra cervical injections of 0.2 mL technetium 99 at 3’O clock and 9’O clock position followed by lymphoscintigraphy was done on preoperative day.Intraoperatively Isosulphan blue dye injection 3 ml each at 3’O clock and 9’O clock position of cervix.Hot nodes and blue nodes were identified and dissected. All nodes were subjected to frozen examination. Then proceeded with Hysterectomy, bilateral salpingo ophorectomy, bilateral pelvic and paraortic node dissection. Statistical analysis done with SPSS software.
Results Lymphoscitigraphy detected 46.66% (14 out of 30) sentinel node in iliac region. 33.3% cases had 1 hot node and 27.8% cases had 2 hot node on right hemipelvis.50% cases had hot node at right external iliac region followed by 27.2% had hot node at right obturator region. 50% cases had 1 hot node and 5.6% had 2 hot node on left hemipelvis.69% had hot node at left external iliac region and 13.4% had hot node at obturator region. 38.9% had blue node on right side and 27.8% had blue node on left side. 1 case of hot para aortic LN. No blue para aortic LN. None of the cases had frozen positive result.
Conclusion Detection rate of sentinel node by lymphoscintigraphy is 46.6%. Combined detection rate of SN using both Technitium 99 and iso sulphan blue dye was 73%.
Disclosure Nothing to disclose.