Sentinel-node biopsy in endometrial cancer: a win–win scenario?

Lymphatic mapping by sentinel lymph-node (SLN) detection offers a means of assessing the lymph-node status of primary tumours with respect to metastases, without having to resort to formal lymphadenectomy. The SLN procedure usually involves injection of radiocolloid at the tumour site the previous day, and injection of patent blue dye just before surgery. The clinical value of SLN biopsy is based on its reliable negative predictive value and high sensitivity to detect metastatic disease. A full lymphadenectomy can necessitate extensive dissection, which might be time consuming and involve morbidity. SLN detection and biopsy is established practice for melanoma and breast cancer, 1 Morton DL Thompson JF Cochran AJ et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med. 2006; 355: 1307-1317 Crossref PubMed Scopus (1472) Google Scholar , 2 Lyman GH Giuliano AE Somerfield MR et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005; 23: 7703-7720 Crossref PubMed Scopus (1498) Google Scholar and will probably become standard of care for vulval cancer within a few years. 3 Van de Zee AGJ Oonk MH De Hullu JA et al. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol. 2008; 26: 884-889 Crossref PubMed Scopus (577) Google Scholar Detection rate and diagnostic accuracy of sentinel-node biopsy in early stage endometrial cancer: a prospective multicentre study (SENTI-ENDO)SLN biopsy with cervical dual labelling could be a trade-off between systematic lymphadenectomy and no dissection at all in patients with endometrial cancer of low or intermediate risk. Moreover, our study suggests that SLN biopsy could provide important data to tailor adjuvant therapy. Full-Text PDF