Sentinel lymph node mapping has the potential to decrease morbidity and optimize the pathologic assessment of identified nodes in women with endometrial cancer.
Accurate surgical staging is the most important prognostic factor in endometrial cancer, SLN mapping can be considered for the surgical staging of apparent uterine-confined malignancy when there is no metastasis demonstrated by imaging studies or no obvious extrauterine disease at exploration.
Many patients undergo a comprehensive lymphadenectomy despite having disease confined to the uterus, resulting in prolonged operating time, additional cost, and potential side effects, such as lower extremity lymphedema. However, a complete lymphadenectomy may have no therapeutic benefit to in patients with early-stage endometrial cancer and add up to the morbidity .
Sentinel lymph node (SLN) mapping, which has been used in other cancer types, may be an acceptable surgical strategy between a complete lymphadenectomy and no nodal evaluation in patients with endometrial cancer. SLN mapping is based on the concept that lymph node metastasis is the result of an orderly process; that is, lymph drains in a specific pattern away from the tumor, and therefore, if the SLN or first node is negative for metastasis, then the nodes after the SLN should also be negative. This approach can help patients avoid the side effects associated with a complete lymphadenectomy, Surgeon experience, adherence to an SLN algorithm, and the use of pathologic “ultrastaging” are key factors for successful SLN mapping.
At sunrise we do SLN mapping for thorough staging , accurate prognosis and appropriate complete treatment. Cervical injection of Indocyanine green (ICG) for SLN Mapping that requires near-infrared camera for localization, provides a very high SLN detection rate.