Introduction Sentinel lymph node (SLN) mapping is becoming the new standard of care in cervical and endometrial carcinoma (CC) (EC), changing the prognosis of patients with unsuspected LN involvement, and avoiding systematic lymphadenectomies in high risk EC. We can also identified low volume metastases (LVM), but we still lack of data about the appropriate adjuvant treatment.
Methods Analysis on a group of patients from our two prospective trials of SNL in EC and CC. we included patients in whom we used indocianine green (ICG). We analysed the final pathology and the adjuvant treatment, with special interest in those with LVM. We analysed the subgroup of patients with aortic lymphadenectomy.
Results 59 patients. 41 EC and 18 CC. we used 1,25 mg of cervical ICG. global detection rate: 98,3%. Bilateral detection rate:91,5%. Pelvic lymphadenectomy in 18 EC and in all CC. aortic in 6 patients. 10 had nodal metastases: All with bilateral SNL. The sensitivity was 100%, no false negative rate. There were no aortic positive nodes without pelvic compromised. In 22 of EC we only performed SLN mapping. 2 of them, initially low risk, had nodal disease. we had 4 LVM, 2 in the low risk EC. They all received radiotherapy.
Conclusion The presence of LVM conditioned the indication of adjuvance. We consider than SLN and selective lymphadenectomy if SLN aren´t found, is a valid option in cases of high risk EC. Because of these results and our experience, we are no longer performing extensive lymphadenectomies.
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