Accuracy of robotic sentinel lymph node detection (RSLND) for patients with endometrial cancer (EC)

Pranjal H. Desai, Patrick Hughes, Daniel H. Tobias, Nana Tchabo, Paul B. Heller, Craig Dise, Brian Slomovitz

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives Lymphadenectomy as a part of the staging for EC patients is controversial. Sentinel lymph node detection has been introduced to determine which patients would benefit from adjuvant therapy and to limit morbidities associated with a full pelvic nodal dissection. The purpose of this study is to evaluate diagnostic accuracy and detection rate of robotic sentinel lymph node detection (RSLND) as a part of the surgical staging for EC.

Results Between 4/2011 and 6/2013, 120 patients with endometrial cancer underwent RSLND. The median age was 62 years (25-87); median BMI was 32 (18-76). Out of 120 patients, only one patient underwent RSLND with fertility preservation; and 119 patients underwent robotic hysterectomy and surgical staging with RSLND. None of the cases was converted to an open procedure. At least 1 SLN was detected in 86% (103/120) of the patients. Bilateral SLNs were detected in 52% (62/120). Positive nodes were identified in 8% (10/120) of the patients. Of those with SLN (+), 50% (5/10) were by ultrastaging (IHC) alone. No patients had positive regional nodes without SLN (+).

Methods A retrospective database of all patients who underwent intraoperative lymphatic mapping using cervical injection methylene blue followed by RSLND as a part of their procedure was reviewed. Sentinel lymph node (SLN) was initially examined by routine Hematoxylin and Eosin (H&E) and ultrastaging by immunohistochemistry (IHC).

Conclusions RSLND using methylene blue cervical injection can identify SLN in most patients with EC. IHC ultrastaging improves the detection of node positive disease when compared to traditional pathological evaluation.

Original languageEnglish (US)
Pages (from-to)196-200
Number of pages5
JournalGynecologic Oncology
Volume135
Issue number2
DOIs
StatePublished - Nov 1 2014

Fingerprint

Robotics
Endometrial Neoplasms
Methylene Blue
Immunohistochemistry
Sentinel Lymph Node
Fertility Preservation
Injections
Hematoxylin
Eosine Yellowish-(YS)
Lymph Node Excision
Hysterectomy
Dissection
Databases
Morbidity

Keywords

  • ltrastaging
  • Robotic
  • Sentinel lymph node detection U

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Accuracy of robotic sentinel lymph node detection (RSLND) for patients with endometrial cancer (EC). / Desai, Pranjal H.; Hughes, Patrick; Tobias, Daniel H.; Tchabo, Nana; Heller, Paul B.; Dise, Craig; Slomovitz, Brian.

In: Gynecologic Oncology, Vol. 135, No. 2, 01.11.2014, p. 196-200.

Research output: Contribution to journalArticle

Desai, Pranjal H. ; Hughes, Patrick ; Tobias, Daniel H. ; Tchabo, Nana ; Heller, Paul B. ; Dise, Craig ; Slomovitz, Brian. / Accuracy of robotic sentinel lymph node detection (RSLND) for patients with endometrial cancer (EC). In: Gynecologic Oncology. 2014 ; Vol. 135, No. 2. pp. 196-200.
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abstract = "Objectives Lymphadenectomy as a part of the staging for EC patients is controversial. Sentinel lymph node detection has been introduced to determine which patients would benefit from adjuvant therapy and to limit morbidities associated with a full pelvic nodal dissection. The purpose of this study is to evaluate diagnostic accuracy and detection rate of robotic sentinel lymph node detection (RSLND) as a part of the surgical staging for EC.Results Between 4/2011 and 6/2013, 120 patients with endometrial cancer underwent RSLND. The median age was 62 years (25-87); median BMI was 32 (18-76). Out of 120 patients, only one patient underwent RSLND with fertility preservation; and 119 patients underwent robotic hysterectomy and surgical staging with RSLND. None of the cases was converted to an open procedure. At least 1 SLN was detected in 86{\%} (103/120) of the patients. Bilateral SLNs were detected in 52{\%} (62/120). Positive nodes were identified in 8{\%} (10/120) of the patients. Of those with SLN (+), 50{\%} (5/10) were by ultrastaging (IHC) alone. No patients had positive regional nodes without SLN (+).Methods A retrospective database of all patients who underwent intraoperative lymphatic mapping using cervical injection methylene blue followed by RSLND as a part of their procedure was reviewed. Sentinel lymph node (SLN) was initially examined by routine Hematoxylin and Eosin (H&E) and ultrastaging by immunohistochemistry (IHC).Conclusions RSLND using methylene blue cervical injection can identify SLN in most patients with EC. IHC ultrastaging improves the detection of node positive disease when compared to traditional pathological evaluation.",
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N2 - Objectives Lymphadenectomy as a part of the staging for EC patients is controversial. Sentinel lymph node detection has been introduced to determine which patients would benefit from adjuvant therapy and to limit morbidities associated with a full pelvic nodal dissection. The purpose of this study is to evaluate diagnostic accuracy and detection rate of robotic sentinel lymph node detection (RSLND) as a part of the surgical staging for EC.Results Between 4/2011 and 6/2013, 120 patients with endometrial cancer underwent RSLND. The median age was 62 years (25-87); median BMI was 32 (18-76). Out of 120 patients, only one patient underwent RSLND with fertility preservation; and 119 patients underwent robotic hysterectomy and surgical staging with RSLND. None of the cases was converted to an open procedure. At least 1 SLN was detected in 86% (103/120) of the patients. Bilateral SLNs were detected in 52% (62/120). Positive nodes were identified in 8% (10/120) of the patients. Of those with SLN (+), 50% (5/10) were by ultrastaging (IHC) alone. No patients had positive regional nodes without SLN (+).Methods A retrospective database of all patients who underwent intraoperative lymphatic mapping using cervical injection methylene blue followed by RSLND as a part of their procedure was reviewed. Sentinel lymph node (SLN) was initially examined by routine Hematoxylin and Eosin (H&E) and ultrastaging by immunohistochemistry (IHC).Conclusions RSLND using methylene blue cervical injection can identify SLN in most patients with EC. IHC ultrastaging improves the detection of node positive disease when compared to traditional pathological evaluation.

AB - Objectives Lymphadenectomy as a part of the staging for EC patients is controversial. Sentinel lymph node detection has been introduced to determine which patients would benefit from adjuvant therapy and to limit morbidities associated with a full pelvic nodal dissection. The purpose of this study is to evaluate diagnostic accuracy and detection rate of robotic sentinel lymph node detection (RSLND) as a part of the surgical staging for EC.Results Between 4/2011 and 6/2013, 120 patients with endometrial cancer underwent RSLND. The median age was 62 years (25-87); median BMI was 32 (18-76). Out of 120 patients, only one patient underwent RSLND with fertility preservation; and 119 patients underwent robotic hysterectomy and surgical staging with RSLND. None of the cases was converted to an open procedure. At least 1 SLN was detected in 86% (103/120) of the patients. Bilateral SLNs were detected in 52% (62/120). Positive nodes were identified in 8% (10/120) of the patients. Of those with SLN (+), 50% (5/10) were by ultrastaging (IHC) alone. No patients had positive regional nodes without SLN (+).Methods A retrospective database of all patients who underwent intraoperative lymphatic mapping using cervical injection methylene blue followed by RSLND as a part of their procedure was reviewed. Sentinel lymph node (SLN) was initially examined by routine Hematoxylin and Eosin (H&E) and ultrastaging by immunohistochemistry (IHC).Conclusions RSLND using methylene blue cervical injection can identify SLN in most patients with EC. IHC ultrastaging improves the detection of node positive disease when compared to traditional pathological evaluation.

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