Evaluation of sentinel lymph node biopsy using radiocolloid in first stage endometrial cancer

¹Institute Of Pathophysiology And Nuclear Medicine " Acad. Isac S. Tadzer", Faculty Of Medicine, University Of "Ss. Cyril And Methodius", Skopje, Republic Of North Macedonia
²University Clinic For Obstetrics And Gynecology, Skopje, Republic Of North Macedonia
³Institute Of Pathology, Faculty Of Medicine, University Of "Ss. Cyril And Methodius", Skopje, Republic Of North Macedonia

INTRODUCTION: Detection of a sentinel lymph node (SLN) in patients with endometrial cancer (EC) reduces the rate of unnecessary systemic lymph dissection. The aim of this study was the appraisal of SLN detection rate, accuracy of the method using 99mTc-SENTI-SCINT and the rate of metastatic nodal involvement in patients with preoperative first stage of EC.

METHODS: A prospective study of SLN biopsy of 41 patients with stage I EC was performed after cervical application of 4mCi 99mTc-SENTI-SCINT. Planar lymphoscintigraphy and SPECT/CT of the pelvis were made, followed by site-specific lymphadenectomy in intermediate-risk patients if no SLN was detected per hemipelvis and pelvic lymphadenectomy in all high-risk patients.

RESULTS: Preoperative detection rate of planar lymphoscintigraphy was 80.49 (95% CI 68.36 - 92.62) and of SPECT/CT 95.12 (95% CI 88.52 - 101.7). The total intraoperative SLN detection rate was 95.12 (95% CI 88.52 - 101.7) per patient, 26.83 (95% CI 19.91 - 33.75) bilaterally. The average number of SLNs removed was 1.6 ą 0.8. The most common anatomical location of SLN was the right external iliac region. SLN metastatic rate was 17%. Both sensitivity and negative predictive value regarding metastatic involvement were 100%.

DISCUSSION AND CONCLUSION: The SLN detection rate, sensitivity and negative predictive value using 99mTc-SENTI-SCINT in patients with EC in our study were high. The application of ultrastaging in the histopathological analysis of the SLN increases the detection of nodal metastases and improves the staging in these patients.

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Anamarija Jankulovska, Sinisha Stojanoski, Sasho Stojcevski, Igor Aluloski, Rubens Jovanovic, Slavica Kostadinova Kunovska, Mile Tanturovski, Nevena Manevska, Gordana Petrusevska, Daniela Miladinova. Evaluation of sentinel lymph node biopsy using radiocolloid in first stage endometrial cancer. J Educ Res Nurs. 2023; 32(2): 103-111

Corresponding Author: Anamarija Jankulovska, Macedonia