[Sentinel lymph node identification using hysteroscopy in patients with endometrial cancer]

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Endometrial carcinoma is the most common gynecologic malignancy, with incidence rates increasing.
• Radical surgery remains the primary treatment modality for endometrial cancer.
• Accurate staging is crucial for effective treatment and prognosis.

Purpose of the Study:

• To assess the feasibility of sentinel lymph node (SLN) detection in endometrial cancer.
• To evaluate hysteroscopic administration of radiocolloid for SLN identification.
• To combine preoperative lymphoscintigraphy with intraoperative gamma-detection probe examination.

Main Methods:

• 21 patients with endometrial cancer underwent hysteroscopic injection of 99mTc-labelled nanocolloid.
• Preoperative lymphoscintigraphy was performed 60 minutes post-injection.
• Intraoperative SLN detection utilized a handheld gamma-detecting probe during surgery.

Main Results:

• Sentinel lymph nodes were detected in 81% (17/21) of patients.
• The mean number of detected SLNs was 2 (range 1-5).
• SLN metastases were detected in one patient with 100% sensitivity and specificity.

Conclusions:

• Sentinel lymph node detection is a promising method for endometrial cancer staging.
• Hysteroscopic radiocolloid application respects natural lymphatic drainage pathways.
• Combining preoperative lymphoscintigraphy and intraoperative gamma probe detection enhances SLN identification.