Article Text
Abstract
Introduction/Background*Main objective of the present study is to discuss the effectiveness and safety of sentinel lymph node in endometrial cancer cases.
Methodology A comprehensive review of published literature in Pubmed, with special focus on meta-analyses and prospective studies, was performed.
Result(s)*Sentinel lymph node (SLN) is indicated for treatment of low and intermediate risk endometrial cancer. Since lymphadenectomy is an important source of morbidity (17.5%) with 2.5% mortality and no proven therapeutic value has been indicated for systematic lymphadenectomy, minimization of approach aims to reduce postoperative morbidity such as lymphedemas. Blood loss, operation time and postoperative complications of SLN are comparable with no lymphadenectomy and significantly decrease compared with systematic lymphadenectomy. SLN detection rates are reported to reach 97% per patient, 87% per hemipelvis and 78% bilaterally. SLNs detected bilaterally are associated with 95.8% sensitivity and over than 98% negative predictive value. Use of SLN strategy is proven to mitigate concern for missed paraaortic micormetastasis, thereafter eliminating risk for postoperative overtreatment. Finally, regarding used regimen, ICG is potentially superior to blue dye as its use was associated with 26.5% increase od SLN dtections rates. Furthermore, a larger dose of ICG is associated with a higher number of retrieved SLNs but not with an increased bilateral DR
Conclusion*SLN is a safe and effective strategy to identify nodal micrometastasis, thereafter optimizing complentary therapy in low and intermediate risk endometrial cancer patients.