RT Journal Article
SR Electronic
T1 Pathology of sentinel lymph nodes: historical perspective and current applications in gynecologic cancer
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 394
OP 401
DO 10.1136/ijgc-2019-001022
VO 30
IS 3
A1 Elizabeth Euscher
YR 2020
UL http://ijgc.bmj.com/content/30/3/394.abstract
AB Efforts to reduce surgical morbidity related to en bloc lymph node removal associated with cancer surgery led to the development of targeted lymph node sampling to identify the lymph node(s) most likely to harbor a metastasis. Through identification of one or only a few lymph nodes at highest risk, the overall number of lymph nodes removed could be markedly reduced. Submission of fewer lymph nodes affords more detailed pathologic examination than would otherwise be practical with a standard lymph node dissection. Such enhanced pathologic examination techniques (ie, ultra-staging) have contributed to increased detection of lymph node metastases, primarily by detection of low volume metastatic disease. Based on the success of sentinel lymph node mapping and ultra-staging in breast cancer and melanoma, such techniques are increasingly used for other organ systems including the gynecologic tract. This review addresses the historical aspects of sentinel lymph node evaluation and reviews current ultra-staging protocols as well as the implications associated with increased detection of low volume metastases.