Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer
Sentinel lymph node (SLN) mapping is becoming an acceptable alternative to full lymphadenectomy for evaluating lymphatic spread in clinical stage I endometrial cancer (EC). While the assessment of pelvic and para-aortic lymph nodes is part of the surgical staging of EC, there is a long-standing deba...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/29/2/96 |
| _version_ | 1827655833866993664 |
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| author | Lina Salman Maria C. Cusimano Zibi Marchocki Sarah E. Ferguson |
| author_facet | Lina Salman Maria C. Cusimano Zibi Marchocki Sarah E. Ferguson |
| author_sort | Lina Salman |
| collection | DOAJ |
| description | Sentinel lymph node (SLN) mapping is becoming an acceptable alternative to full lymphadenectomy for evaluating lymphatic spread in clinical stage I endometrial cancer (EC). While the assessment of pelvic and para-aortic lymph nodes is part of the surgical staging of EC, there is a long-standing debate over the therapeutic value of full lymphadenectomy in this setting. Although lymphadenectomy offers critical information on lymphatic spread and prognosis, most patients will not derive oncologic benefit from this procedure as the majority of patients do not have lymph node involvement. SLN mapping offers prognostic information while simultaneously avoiding the morbidity associated with an extensive and often unnecessary lymphadenectomy. A key factor in the decision making when planning for EC surgery is the histologic subtype. Since the risk of lymphatic spread is less than 5% in low-grade EC, these patients might not benefit from lymph node assessment. Nonetheless, in high-grade EC, the risk for lymph node metastases is much higher (20–30%); therefore, it is crucial to determine the spread of disease both for determining prognosis and for tailoring the appropriate adjuvant treatment. Studies on the accuracy of SLN mapping in high-grade EC have shown a detection rate of over 90%. The available evidence supports adopting the SLN approach as an accurate method for surgical staging. However, there is a paucity of prospective data on the long-term oncologic outcome for patients undergoing SLN mapping in high-grade EC, and more trials are warranted to answer this question. |
| first_indexed | 2024-03-09T22:13:09Z |
| format | Article |
| id | doaj.art-42aed59a04064596b4233272b0b12984 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T22:13:09Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-42aed59a04064596b4233272b0b129842023-11-23T19:27:23ZengMDPI AGCurrent Oncology1198-00521718-77292022-02-012921123113510.3390/curroncol29020096Sentinel Lymph Node Mapping in High-Grade Endometrial CancerLina Salman0Maria C. Cusimano1Zibi Marchocki2Sarah E. Ferguson3Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Toronto, 610 University Ave, Toronto, ON M5G2M9, CanadaDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Toronto, 610 University Ave, Toronto, ON M5G2M9, CanadaDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Toronto, 610 University Ave, Toronto, ON M5G2M9, CanadaDivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Toronto, 610 University Ave, Toronto, ON M5G2M9, CanadaSentinel lymph node (SLN) mapping is becoming an acceptable alternative to full lymphadenectomy for evaluating lymphatic spread in clinical stage I endometrial cancer (EC). While the assessment of pelvic and para-aortic lymph nodes is part of the surgical staging of EC, there is a long-standing debate over the therapeutic value of full lymphadenectomy in this setting. Although lymphadenectomy offers critical information on lymphatic spread and prognosis, most patients will not derive oncologic benefit from this procedure as the majority of patients do not have lymph node involvement. SLN mapping offers prognostic information while simultaneously avoiding the morbidity associated with an extensive and often unnecessary lymphadenectomy. A key factor in the decision making when planning for EC surgery is the histologic subtype. Since the risk of lymphatic spread is less than 5% in low-grade EC, these patients might not benefit from lymph node assessment. Nonetheless, in high-grade EC, the risk for lymph node metastases is much higher (20–30%); therefore, it is crucial to determine the spread of disease both for determining prognosis and for tailoring the appropriate adjuvant treatment. Studies on the accuracy of SLN mapping in high-grade EC have shown a detection rate of over 90%. The available evidence supports adopting the SLN approach as an accurate method for surgical staging. However, there is a paucity of prospective data on the long-term oncologic outcome for patients undergoing SLN mapping in high-grade EC, and more trials are warranted to answer this question.https://www.mdpi.com/1718-7729/29/2/96endometrial cancerhigh-gradesentinel lymph node |
| spellingShingle | Lina Salman Maria C. Cusimano Zibi Marchocki Sarah E. Ferguson Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer Current Oncology endometrial cancer high-grade sentinel lymph node |
| title | Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer |
| title_full | Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer |
| title_fullStr | Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer |
| title_full_unstemmed | Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer |
| title_short | Sentinel Lymph Node Mapping in High-Grade Endometrial Cancer |
| title_sort | sentinel lymph node mapping in high grade endometrial cancer |
| topic | endometrial cancer high-grade sentinel lymph node |
| url | https://www.mdpi.com/1718-7729/29/2/96 |
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