Detection rate and diagnostic accuracy of sentinel-node biopsy in early stage endometrial cancer: a prospective...

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Clinical Trials

Background:

• Retrospective studies indicated sentinel lymph node (SLN) identification is feasible in endometrial cancer.
• A prospective, multicentre cohort study was conducted to evaluate SLN procedure efficacy.
• The study aimed to assess detection rates and diagnostic accuracy for predicting pelvic lymph node status.

Purpose of the Study:

• To evaluate the detection rate and diagnostic accuracy of sentinel lymph node (SLN) biopsy.
• To predict pathological pelvic-node status in early-stage endometrial cancer patients.
• To determine the negative predictive value (NPV) of SLN biopsy per hemipelvis.

Main Methods:

• Prospective, multicentre cohort study involving patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-II endometrial cancer.
• Pelvic SLN assessment using cervical dual injection (technetium and patent blue) followed by systematic pelvic-node dissection.
• Histopathological examination of all lymph nodes, with serial sectioning and immunohistochemistry for SLNs.

Main Results:

• 133 patients were enrolled; at least one SLN was detected in 111 (88%) eligible patients.
• The negative predictive value (NPV) was 100% per hemipelvis and 97% per patient.
• Immunohistochemistry identified metastases missed by conventional histology in 8% of patients with detected SLNs, upstaging 10-15% of patients.

Conclusions:

• Sentinel lymph node (SLN) biopsy with cervical dual labelling offers a viable alternative to systematic lymphadenectomy or no dissection for low/intermediate-risk endometrial cancer.
• SLN biopsy provides crucial data for tailoring adjuvant therapy decisions.
• The procedure demonstrated high accuracy in predicting nodal status, with minimal complications.