Introduction/Background*Comparing the anatomical distribution of pelvic sentinel lymph nodes (SLN) in cervical and endometrial cancer.
Methodology Detailed SLN mapping results were prospectively retrieved in cervical (n=145) or high risk endometrial cancer (n=201) patients. Cervically injected Indocyanine Green (ICG), allowing for reinjection, was used as tracer. An anatomically based definition of SLNs was adhered to evaluating the upper (UPP) and lower (LPP) paracervical lymphatic pathways. The positions of SLNs were intraoperatively depicted on an anatomical chart. A completory pelvic lymphadenectomy was performed in all patients and in addition, xx underwent a paraaortic lympadenectomy. Mapping rates and anatomical distribution of SLNs were compared between groups.
Result(s)*The bilateral mapping rate was 97.9% and 95.0% for cervical and endometrial cancer respectively. All pelvic node positive women (cervical cancer n=19, endometrial cancer n=37) had at least one metastatic SLN. The proportion of typically positioned (interiliac and proximal obturator fossa) SLNs along the UPP was similar between groups (78.1% vs 82.1%, p=.09) with a similar distribution of SLN metastases; 54.1% and 48.6% respectively were located in the obturator fossa. Anatomically typical positions could not be defined along the LPP.
Conclusion*A cervical injection of ICG results in similar anatomical distributions of SLNs and SLN metastases in cervical and endometrial cancer with no false negative SLNs. Provided adherence to an anatomically defined algorithm sensitivity results for a SLN concept in endometrial and cervical cancer can be pooled. Hence, an SLN concept can be implemented in cervical cancer patients.
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