Sentinel lymph node (SLN) mapping accurately identifies node-positive, high-risk endometrial cancer, the preliminary results of an ongoing study at The University of Texas MD Anderson Cancer Center indicate.
In women with high-risk endometrial cancer, the current standard of care for initial treatment and staging is hysterectomy plus complete pelvic and para-aortic lymphadenectomy. However, the surgery carries a risk of intraoperative and postoperative morbidities. SLN mapping, in which dye is injected into the cervix to help surgeons locate the SLNs and remove them for biopsy, is less invasive than the standard approach.
“If we could identify patients with positive nodes yet not have to do a full lymphadenectomy, we could potentially decrease the morbidity for patients and still appropriately determine postoperative therapy,” said Pamela Soliman, M.D., an associate professor in the Department of Gynecologic Oncology and Reproductive Medicine.
Dr. Soliman is the principal investigator of the ongoing study, whose purpose is to compare SLN mapping and positron emission tomography/computed tomography (PET/CT) for detecting lymph node metastases. In the single-institution prospective study, patients with high-risk, grade 3 endometrial cancer undergo preoperative PET/CT and intraoperative SLN mapping followed by standard treatment with hysterectomy and complete lymphadenectomy.
Of 60 evaluable patients, at least one SLN was identified in 56 (93%), and bilateral SLNs were identified in 37 (62%). Each patient who had a disease-positive lymph node on final pathology had at least one positive SLN, for a sensitivity of 100%. The false-negative rate was 0%.
“If we continue to see such promising results, sentinel lymph node mapping could change the overall management of endometrial cancer, much like we have seen it do in other diseases,” Dr. Soliman said. She added that the PET/CT data are still being reviewed.
Dr. Soliman and her colleagues presented their findings at the Society of Gynecologic Oncology’s Annual Meeting on Women’s Cancer in Chicago in March.
OncoLog, May 2015, Volume 60, Issue 5