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Annals of Oncology Advance Access originally published online on August 20, 2007
Annals of Oncology 2007 18(11):1799-1803; doi:10.1093/annonc/mdm334
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© 2007 European Society for Medical Oncology

gynecologic tumors

The sentinel node concept in endometrial cancer: histopathologic validation by serial section and immunohistochemistry

Y. Delpech1, A. Cortez2, C. Coutant1, P. Callard2, S. Uzan1, E. Darai1 and E. Barranger1,3,*

1 Department of Gynecologic and Breast Cancers
2 Department of Pathology, Hôpital Tenon
3 Department of Gynecologic-Obstetrics, Hôpital Lariboisiere, Assistance Publique des Hôpitaux de Paris, Paris, France

* Correspondence to: Emmanuel Barranger, MD, Department of Gynecologic-Obstetrics, Hôpital Lariboisiere, 2 rue Ambroise-Pare, 75010 Paris, France. Tel: + 33-1-49-95-84-09; Fax: (33) 1 49 95 84 09; E-mail: emmanuel.barranger{at}lrb.aphp.fr

Background: The sentinel node (SN) is defined as the first node in the lymphatic system that drains a tumor site. If the SN is not metastatic, then all other nodes should also be disease-free. We used serial sections and immunohistochemical (IHC) staining to examine both SN and non-sentinel nodes (non-SNs).

Patients and methods: Twenty-three patients (median age 69 years) with early endometrial cancer underwent a laparoscopic SN procedure based on a combined detection method, followed by complete laparoscopic pelvic lymphadenectomy. If the SN was free of metastasis by both hematoxylin and eosin (H&E) and IHC staining, all non-SNs were also examined by the combined staining method.

Results: SNs were identified in 19 patients (82.6%). A total of 47 SNs were removed (mean 2.5). Ten SNs (21.3%) from five patients (26.3%) were found to be metastatic at the final histologic assessment. In 14 patients, no metastatic SN involvement was detected by H&E and IHC staining. In these 14 patients, 120 non-SNs were examined by serial sectioning and IHC, and none were found to be metastatic.

Conclusion: The SN procedure appears to reliably predict the metastatic status of the regional lymphatic basin in patients with early endometrial cancer.

Key words: endometrial cancer, immunohistochemistry, micrometastasis, pathologic staging, patent blue, radiocolloid, sentinel node

Received for publication January 30, 2007. Revision received May 21, 2007. Accepted for publication May 22, 2007.


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[Abstract] [Full Text] [PDF]


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