Diagnostic accuracy of sentinel lymph node biopsy in women with early-stage endometrial cancer

Objective: The objective of the present study was to evaluate the accuracy of the sentinel lymph node (SLN) detection procedure in Serbian sample of women with early-stage endometrial cancer (EC). Materials and Methods: In the period from March, 2015 to May 2016, all consecutive patients with histologically confirmed EC, were considered for enrolment in the study. Exclusion criteria included preoperative FIGO Stages II-IV, previous surgery that could influence the uterine lymphatic drainage, history of congenital uterus anomalies, duplex malignancies or deep vein thrombosis on lower extremities, and allergies to the contrast agent. Finally, 27 patients underwent SLN detection, followed by systematic pelvic lymphadenectomy. Demographic, surgical, and pathologic data on all patients were evaluated. Results: The SLNs were identified in 25 patients, with overall detection rate of 92.6%. Twenty-two (81.5%) patients had bilateral, while 11.15% had unilateral intraoperative visualization of SLNs. Of the seven females with positive SLNs, at definitive histology evaluation, pelvic non-SLNs were metastatic in four (57.1%) cases and negative in three (42.9%) cases. The false-negative rate of sentinel procedure was 0%. The evaluation of prognostic values of SLN status, for prediction of presence of metastases in non-SLNs showed the negative predicive value of 100%, and the positive predictive value of 57.1%. Additionally, the sensitivity of SLN method in sample of women with early-stage EC was 100%, while the specificity was 86.9%. Conclusions: SLN procedure has good diagnostic performance and is reliable in prediction of the metastatic status of the regional pelvic lymph nodes in women with early-stage EC.

Sentinel nodes; Endometrial cancer; Pelvic lymphadenectomy.

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