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Laparoscopic Sentinel Node Procedure Using a Combination of Patent Blue and Radiocolloid in Women With Endometrial Cancer

From the Departments of Gynecologic and Breast Cancers (EB, SU, ED), Pathology (AC, PC), and Nuclear Medicine (DG), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France.

Correspondence: Address correspondence and reprint requests to: Emmanuel Barranger, MD, Department of Gynecologic and Breast Cancers, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France; Fax: 33-1-56-01-60-62; E-mail: emmanuel.barranger{at}tnn.ap-hop-paris.fr

Background: We assessed the feasibility of a laparoscopic sentinel node (SN) procedure based on the combined use of radiocolloid and patent blue labeling in patients with endometrial cancer.

Methods: Seventeen patients (median age, 69 years) with endometrial cancer of stage I (16 patients) or stage II (1 patient) underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically. After the SN procedure, all patients underwent complete laparoscopic pelvic lymphadenectomy and either laparoscopically assisted vaginal hysterectomy (16 patients) or laparoscopic radical hysterectomy (1 patient).

Results: SNs (mean number per patient, 2.6; range, 1–4) were identified in 16 (94.1%) of the 17 patients. Macrometastases were detected in three SNs from two patients by hematoxylin and eosin staining. In three other patients, immunohistochemical analysis identified six micrometastatic SNs and one SN containing isolated tumor cells. No false-negative SN results were observed.

Conclusions: An SN procedure based on a combination of radiocolloid and patent blue is feasible in patients with early endometrial cancer. Combined use of laparoscopy and this SN procedure permits minimally invasive management of endometrial cancer.

Key Words: Sentinel node • Laparoscopy • Patent blue • Radiocolloid • Endometrial cancer

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