A Feasibility Study of Sentinel Lymph Node Biopsy in Endometrial Cancer Using Technetium 99m Nanocolloid

To study the feasibility of sentinel node biopsy in early-stage endometrial cancer and to analyse the detection rate of sentinel lymph node (SLN) using preoperative cervical injection of Tc99m nanocolloid. Thirty-five patients with preoperative histological diagnosis of endometrial cancer without any extrauterine involvement on imaging were included in the study. Sentinel node mapping was done by cervical injection of Tc99m nanocolloid on the evening before surgery. Scintigraphic images were taken using gamma camera. Intraoperatively, nodes showing radioactivity were detected using hand-held gamma probe, dissected out separately and labelled as sentinel lymph nodes. Detection rate was calculated and analysed with respect to various parameters. Sentinel lymph node biopsy (SLNB) is feasible in endometrial cancer using cervical injection of Tc99m nanocolloid. SLN detection was done in 33 (94.3%) out of 35 patients. Bilateral detection was feasible in 19 patients (54.3%) with detection in left and right hemipelvis being 74.3%. Detection rate of SLN was 93.7% in endometrioid adenocarcinoma. Sentinel node was detected in all the patients with non-endometrioid histology. The SLNB using cervical injection of Tc99m nanocolloid is feasible in endometrial cancer. It is a safe and easily reproducible technique with good detection rate and high sensitivity. Stage of the tumour, grade and myometrial invasion do not seem to have an influence on sentinel node detection. Cervical involvement, enlarged lymph nodes and obstructed lymphatics can affect sentinel node mapping adversely.