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Sentinel lymph node detection in early stage ovarian cancer: the primary experience in N. N. Blokhin national medical Research Center of Oncology

https://doi.org/10.17650/2686-9594-2022-12-3-19-25

Abstract

Background. Surgical staging including pelvic and para-aortic lymphadenectomy is recommended in patients with clinical early-stage epithelial ovarian cancer. The therapeutic role of pelvic and para-aortic lymphadenectomy is still under debate, this procedure can increase risk of intra- and post-operative complications. using the sentinel lymph node (SLN) detection in early stage ovarian cancer in very promising and decreases the level of surgical damage. But nowadays the data on effectiveness, safety sensitivity and specificity of SLN are limited and the technique has to be standardized.

Aim. To determine the feasibility of the SLN detection procedure using indocyanine green in early stage ovarian cancer.

Materials and methods. four patients with clinical stage I epithelial ovarian cancer underwent SLN detection using indocyanine green. The tracer was injected into hilum of the ovary or ovarian ligament stumps in the case of previous adnexectomy. SLN were detected in infrared spectrum. Systemic retroperitoneal lymph node dissection of the pelvic and paraaortic areas was performed after SLN being removed. frozen section of was not performed in this study.

Results. SLN were detected in paraaortic area in three of four patients. no one of patients had metastatic disease.

Conclusion. The primary experience demonstrates SLN mapping of the ovary being feasible. Prospective study is required to evaluate sensitivity and specificity of SLn detection in early stage ovarian cancer.

About the Authors

M. N. Tikhonovskaya
N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Маria Nikolaevna Tikhonovskaya

24 Kashirskoe Shosse, Moscow 115478



A. S. Shevchuk
N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; Department of Oncology and Radiation Therapy, Faculty of Medicine, N. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

1 Ostrovityanova St., Moscow 117997



References

1. The state of oncological care for the population of Russia in 2020. Eds.: Kaprin A.D., Starinskiy V.V., Shakhzadova A.O. Moscow: MNIOI im. P.A. Herzen – branch of the NMIC of Radiology of Ministry of Health of Russia, 2021. 239 p.

2. Ovarian cancer/fallopian tube cancer/primary peritoneal cancer. Clinical recommendations of the Association of Oncologists of Russia. 2020. Available at: https://oncology-association.ru.

3. Colombo N., Sessa C., du Bois A. et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol 2019;30:672–705. DOI: 10.1093/annonc/mdz062

4. Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer National Comprehensive Cancer Network Guidelines Version 1.2022. Available at: https://www.nccn.org/guidelines.

5. Trimbos B., Timmers P., Pecorelli S. et al. Surgical staging and treatment of early ovarian cancer: long-term analysis from a randomized trial. J Nat Can Inst 2010;102(13):982–7. DOI: 10.1093/jnci/djq149

6. Piver M.S., Barlow J.J., Lele S.B. et al. Incidence of subclinical metastasis in stage I and II ovarian carcinoma. Obstet Gynecol 1978;52(1):1004.

7. Kleppe M., Wang T., Van Gorp T. et al. Lymph node metastasis in stages I and II ovarian cancer: a review. Gynecol Оncol 2011;123(3):610–4. DOI: 10.1016/j.ygyno.2011.09.013

8. Powless C.A., Aletti G.D., Bakkum-Gamez J.N. et al. Risk factors for lymph node metastasis in apparent early-stage epithelial ovarian cancer: implications for surgical staging. Gynecol Oncol 2011;122(3):536–40. DOI: 10.1016/j.ygyno.2011.05.001

9. Hengeveld E.M., Zusterzeel P.L.M., Lajer H. et al. the value of surgical staging in patients with apparent early stage epithelial ovarian carcinoma. Gynecol Оncol 2019;154(2):308–13. DOI: 10.1016/j.ygyno.2019.06.006

10. Bizzarri N., du Bois A., Fruscio R. et al. Is there any therapeutic role of pelvic and para-aortic lymphadenectomy in apparent early stage epithelial ovarian cancer? Gynecol Oncol 2021;160(1):56–63. DOI: 10.1016/j.ygyno.2020.10.028

11. El-Ghobashy A.E., Saidi S.A. Sentinel node sampling in gynaecological cancers: techniques and clinical applications. Eur J Surg Oncol 2009;35:675–85. DOI: 10.1016/j.ejso.2008.09.004

12. Mkrtchyan G.B., Berlev I.V., Trifanov Yu.N. et al. Experience in using the fluorescent method for mapping sentinel lymph nodes in patients with cervical cancer. Opukholi zhenskoy reproduktivnoy sistemy = Tumors of the female reproductive system 2018;14(4):43–9. (In Russ.)

13. Ibragimov Z.N., Mikaya, N.A., Trifanov Yu.N. et al. Detection of sentinel lymph nodes by indocyanine green (ICG) in patients with endometrial cancer. Akusherstvo i ginekologiya = Obstetrics and Gynecology 2020;(S1):105–11.

14. Dell’Orto F., Laven P., Delle Marchette M. et al. Feasibility of sentinel lymph node mapping of the ovary: a systematic review. Int J Gynecol Cancer 2019;29:1209–15. DOI: 10.1136/ijgc-2019-000606

15. Van Manen L., Handgraaf H.J.M., Diana M. et al. a practical guide for the use of indocyanine green and methylene blue in fluorescence-guided abdominal surgery. J Surg Oncol 2018;118:283–300. DOI: 10.1002/jso.25105

16. Kleppe M., Brans B., Van Gorp T. et al. the detection of sentinel nodes in ovarian cancer: a feasibility study. J Nucl Med 2014;55:1799–804. DOI: 10.2967/jnumed.114.144329

17. Lago V., Bello P., Montero B. et al. Clinical application of the sentinel lymph node technique in early ovarian cancer: a pilot study. Int J Gynecol Cancer 2019;29:377–81. DOI: 10.1136/ijgc-2018-000049

18. Laven P., Kruitwagen R., Zusterzeel P. et al. Sentinel lymph node identification in early stage ovarian cancer: is it still possible after prior tumor resection? J Ovarian Res 2021;14(1):1–6. DOI: 10.1186/s13048-021-00887-w

19. Lago V., Bello P., Montero B. et al. Sentinel lymph node technique in early- stage ovarian cancer (SENTOV): a phase II clinical trial. Int J Gynecol Cancer 2020;30:1390–6. DOI: 10.1136/ijgc-2020-001289


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