Evaluation and mapping of sentinel lymph node in patients with gynecological malignancies

AIM: Sentinel lymph node mapping is becoming an alternative to systemic lymph node dissection to assess lymphatic spread in endometrial and cervical cancer patients. Although evaluation of pelvic and paraaortic lymph nodes is an important part of surgical staging, there has long been a debate about the therapeutic value of systemic lymph node dissection. The aim of this study was to perform sentinel lymph node mapping in patients with endometrial and cervical cancer and to compare the clinicopathologic outcomes and morbidity of patients undergoing sentinel lymph node dissection with those undergoing systemic lymph node dissection. MATERIALS AND METHODS: In our clinic, patients with histopathologic diagnosis of endometrial intraepithelial neoplasia, endometrial cancer, cervical cancer who underwent sentinel lymph node dissection and patients aged 30-80 years who underwent systemic lymph node dissection were retrospectively scanned from the hospital system. RESULTS: The overall sentinel lymph node detection rate for endometrial cancer was 66.7% and bilateral detection rate was 20.3%. According to the results of sentinel lymph node biopsy performed with methylene blue in endometrial cancer patients, sensitivity was 100%, specificity was 100%, positive predictive value was 100% and negative predictive value was 100%. The overall detection rate of sentinel lymph node in cervical cancer patients was 100%, bilateral detection rate was 55.6%, and unilateral detection rate was 44.4%. According to the results of sentinel lymph node biopsy performed with methylene blue in cervical cancer patients, sensitivity was 75%, specificity 100%, positive predictive value 100%, negative predictive value 83.3%. CONCLUSION: Endometrial and cervical cancer patients who undergo sentinel lymph node dissection have shorter operative times and fewer complications. Sentinel lymph node mapping improves patients' quality of life, reduces morbidity, and is reliable for lymph node metastasis detection. Sentinel lymph node mapping can be considered as an alternative to systemic lymph node dissection. Keywords: Cervical cancer, endometrial cancer, methylene blue, sentinel lymph node.