Sentinel lymph node mapping and staging in endometrial cancer: A Society of Gynecologic Oncology literature review with consensus recommendations

Abstract

The emphasis in contemporary medical oncology has been "precision" or "personalized" medicine, terms that imply a strategy to improve efficacy through targeted therapies. Similar attempts at precision are occurring in surgical oncology. Sentinel lymph node (SLN) mapping has recently been introduced into the surgical staging of endometrial cancer with the goal to reduce morbidity associated with comprehensive lymphadenectomy, yet obtain prognostic information from lymph node status. The Society of Gynecologic Oncology's (SGO) Clinical Practice Committee and SLN Working Group reviewed the current literature for preparation of this document. Literature-based recommendations for the inclusion of SLN assessment in the treatment of patients with endometrial cancer are presented. This article examines.

Keywords: Consensus recommendation; Endometrial cancer; Literature review; Pathology & clinical outcomes; Sentinel lymph node mapping; Surgical staging.

Conflict of interest statement

Conflict of Interest Statement

We declare that there are no direct conflicts of interest associated with this manuscript, except the following relationships:

1. Dr. Holloway reports personal fees from Intuitive Surgical, Inc., outside the submitted work;

2. Dr. Boggess reports personal fees from Intuitive Surgical, Inc., outside the submitted work;

3. Dr. Lowery reports personal fees from AstraZeneca, Inc., outside the submitted work.

Copyright © 2017 Elsevier Inc. All rights reserved.

Figures

Figure 1.

Example of left pelvic sentinel lymph node (SLN) following indocyanine green (ICG) cervical injection in endometrial cancer. The lymphatic trunk, SLN, and secondary node are seen. Colored segmented fluorescence (CSF) mode (Novadaq, Ontario) allows the surgeon to see the operative field in four different modes (picture in picture), including a high-definition colored image (left upper quadrant), SPY (black and white with highest precision), green overlay PINPOINT®, and CSF with a color gradient of fluorescent intensity uptake (red highest, blue lowest).