Dr. Hellmann on Sentinel Lymph Node Mapping in Endometrial Cancer

Mira Hellmann, MD, gynecologic oncologist and assistant professor, John Theurer Cancer Center, Hackensack University Medical Center, discusses the use of sentinel lymph node mapping in patients with endometrial cancer.

Minimally invasive surgical approaches have taken on a greater role in endometrial cancer and vulvar cancers which have, in turn, led to improved quality of life for patients. Sentinel lymph node mapping is typically done laparoscopically or robotically. These techniques are done in lieu of a complete lymph node dissection to avoid complications such as lymphedema, pain, and increased risk of infection and bleeding, explains Hellmann.

In the FIRES trial (NCT01673022), investigators compared the sensitivity and negative predictive value of sentinel lymph node mapping versus lymphadenectomy in detecting metastatic endometrial cancer. Data showed a 99.6% negative predictive value with sentinel lymph node mapping, indicating that it can safely replace lymphadenectomy for staging, says Hellmann. However, no randomized data suggest that patients who undergo sentinel lymph node mapping have the same oncologic outcomes as those who don’t, adds Hellman.