Robotic sentinel node mapping in clinical stage 1 endometrial cancer using methylene blue dyes using the robotic platform

Abstract

PURPOSE: Endometrial cancer is a surgically staged cancer. We examined our preliminary experience with sentinel lymph node (SLN) mapping in early stage endometrial cancer using methylene blue dyes. METHOD: Retrospective review of all clinically stage 1 endometrial cancer staged surgically using the robotic platform. Logistic regression models were built to predict nodal metastasis taking into account age, grade, histology, depth of myometrial invasion, cervical involvement, and use of SLN mapping. RESULTS: Four hundred sixty-nine patients were reviewed. Sixty patients had SLN mapping (13%). Four hundred nine patients underwent standard lymphadenectomy with five documented nodal metastasis (1.2%). Five nodal metastasis (8.3%) were seen in the SLN patients. In the logistic model, the application of SLN mapping was significantly associated with diagnosed nodal metastasis (OR 7.74; 95% CI, 2.04-29.3; P = .003) together with nonendometroid histology (OR 5.05; 95% CI, 1.27-20.12; P = .022). CONCLUSION: SLN mapping protocol using methylene blue significantly identifies more nodal metastasis than standard lymphadenectomy.