The concept of sentinel lymph node (SLN) surgery is widely used in different tumor types to assess whether the cancer has spread to the first lymph node in the lymph drainage pathway, called the SLN. Although complete pelvic and para-aortic lymphadenectomy has been shown to detect up to 250 lymph nodes, radical lymphadenectomy has been associated with serious potential morbidity and there is therefore a great difference in the extent of lymph node dissection between different centers. The more lymph nodes are removed, the higher the likelihood of detecting metastases. There is 14% (range 6.1–29.6%) chance of finding lymph node metastases, implicating pathological advanced stage disease with an indication for adjuvant chemotherapy. The International Federation of Gynecology and Obstetrics recommends surgical staging in patients with clinical early-stage epithelial ovarian cancer (EOC) including pelvic and para-aortic lymphadenectomy to detect lymph node metastases. In this study we showed that SLN procedure after (previous) resection of the tumor seems inferior to detect sentinel nodes when compared to injection of the tracer in the ovarian ligaments before tumor resection. At least one SLN was identified in 3 patients, resulting in a rather low detection rate of 27,3%. ResultsĪ total of 11 patients were included in the study, the sentinel node (SLN) procedure was completed in all 11 patients. After an interval of at least 15-min, the sentinel node(s) were identified using either the gamma-probe and / or blue dye. Blue dye and a radioactive isotope were injected in the stumps of the ligamentum ovarium proprium and the ligamentum infundibulo-pelvicum. Patients who underwent laparotomy with frozen section confirming an ovarian malignancy, and those who underwent a second staging laparotomy after prior resection of a malignant ovarian mass, were included. in the event that a frozen section confirms malignancy. This study aims to investigate whether the SLN identification is also feasible in patients whose ovarian tumor has already been resected with injection of the tracer into the ovarian ligaments stumps, i.e. Sentinel lymph node (SLN) detection in ovarian cancer is feasible when tracers are injected before the pathological ovary is resected.
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