Controversies in the Treatment of Early Stage Endometrial Carcinoma

Despite the publication of numerous studies, including some multicentered randomized controlled trials, there continues to be vigorous debate regarding the optimal management of early stage endometrial cancer, including the extent of surgery and the role of adjuvant chemotherapy and radiation. Resolving these questions has become increasingly important in view of the increase of endometrial cancer, related to the aging population and the alarming incidence of obesity. Furthermore, there are more surgical challenges encountered when operating on elderly patients or on patients with increased BMI and the associated comorbidities, such as diabetes, hypertension, heart disease, and pulmonary dysfunction. This paper will focus on the advantages of minimally invasive surgery, the value of lymphadenectomy including sentinel lymph node mapping, and some of the current controversies surrounding adjuvant chemotherapy and radiation.

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A feasibility study of sentinel lymph node mapping by cervical injection of a tracer in Japanese women with early stage endometrial cancer

Taiwanese Journal of Obstetrics and Gynecology ◽

10.1016/j.tjog.2018.06.012 ◽

2018 ◽

Vol 57 (4) ◽

pp. 541-545 ◽

Cited By ~ 4

Author(s):

Chisa Shimada ◽

Yukiharu Todo ◽

Hiroyuki Yamazaki ◽

Sho Takeshita ◽

Kazuhira Okamoto ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Feasibility Study ◽

Early Stage ◽

Sentinel Lymph Node Mapping ◽

Japanese Women ◽

Lymph Node Mapping ◽

Early Stage Endometrial Cancer

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Correction to: The impact of different doses of indocyanine green on the sentinel lymph-node mapping in early stage endometrial cancer

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-018-2741-2 ◽

2018 ◽

Vol 144 (11) ◽

pp. 2193-2193

Author(s):

Andrea Papadia ◽

Alessandro Buda ◽

Maria Luisa Gasparri ◽

Giampaolo Di Martino ◽

Beatrice Bussi ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Indocyanine Green ◽

Early Stage ◽

Sentinel Lymph Node Mapping ◽

Lymph Node Mapping ◽

The Impact ◽

Early Stage Endometrial Cancer ◽

Different Doses

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Sentinel Lymph Node Mapping in Early Stage Endometrial Cancer Patients in Low-Resource Settings

Current Women s Health Reviews ◽

10.2174/1573404817999201228192259 ◽

2020 ◽

Vol 17 ◽

Author(s):

Mahmoud Abubakr Negm ◽

Ashraf Nasr Refaie ◽

Magdi Ragab El-Sayed ◽

Hesham R. Abdel Azeez ◽

Abdalla Hassan Gad ◽

...

Keyword(s):

Methylene Blue ◽

Endometrial Cancer ◽

Lymph Node ◽

Detection Rate ◽

Early Stage ◽

False Negative ◽

False Negative Rate ◽

Sentinel Lymph Node Mapping ◽

Lymph Node Mapping ◽

Early Stage Endometrial Cancer

Background:: Lymph node status has a prognostic role in endometrial cancer patients and it determines the adjuvant therapy to be administered postoperatively. Complete lymphadenectomy carries the risk of serious complications. Sentinel lymph node mapping (SLN) may be a good option to reduce these complications. Cervical injection of methylene blue may be a suitable technique for SLN mapping, which can be applied in low-resource institutes. Objective:: Assessment of the detection rate, sensitivity and false negative rate of SLN mapping using cervical injection of methylene blue. Methods:: A total of 76 patients with early stage endometrial cancer were included. Methylene blue was injected into the cervix prior to surgery and open surgical approach was used. SLNs were detected by direct visualization of stained lymph nodes after opening of pelvic spaces. SLNs were excised and pelvic lymphadenectomy was performed. Para-aortic lymphadenectomy was performed when indicated and surgically feasible. Specimens were examined by H&E staining. Results:: The SLN detection rate was 47.4% and all detected SLNs were pelvic nodes. All patients with lymph node metastasis had metastatic disease in their SLNs. The technique had 100% sensitivity, 100% negative predictive value and a 0% false negative rate. An inverse relationship between SLN detection and BMI was detected. Conclusion:: Cervical injection of methylene blue dye with an open approach to detect SLNs in patients with early stage endometrial cancer has a low detection rate. The most important factor associated with failed mapping is increased BMI. Further trials are needed to investigate the usefulness of this technique.

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