Our Summary

This research paper examines the use of a procedure called sentinel lymph node biopsy in women with endometrial (uterine) cancer who had a hysterectomy. The sentinel lymph node biopsy involves removing only a few lymph nodes that are most likely to have cancer cells, which could potentially reduce negative side effects compared to the traditional removal of many lymph nodes, known as lymphadenectomy. However, there’s limited data on how effective this procedure is or how often it’s used.

Researchers used a database to study women with uterine cancer who underwent a hysterectomy between 2011 and 2015. They found that out of over 28,000 patients, around 33% did not have any lymph node assessment, 62% had a lymphadenectomy, and about 5% had a sentinel lymph node biopsy. The biopsy procedure was most commonly performed in women who had a robotic-assisted hysterectomy.

Over time, the use of the sentinel lymph node biopsy increased, particularly in women who had a robotic-assisted hysterectomy. The study also found that for women who had a less invasive form of hysterectomy, the sentinel lymph node biopsy was associated with a shorter hospital stay and lower costs compared to lymphadenectomy.

FAQs

  1. What is a sentinel lymph node biopsy and how is it different from a traditional lymphadenectomy?
  2. According to the research, what percentage of women with uterine cancer who had a hysterectomy also had a sentinel lymph node biopsy between 2011 and 2015?
  3. Did the study suggest any benefits of the sentinel lymph node biopsy compared to the traditional lymphadenectomy in women who had a less invasive form of hysterectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is that it is a minimally invasive procedure that can help determine if cancer has spread to the lymph nodes without the need for a full lymph node dissection. This can potentially reduce the risk of complications and improve recovery time. It is important to discuss the benefits and risks of this procedure with your doctor to determine if it is the best option for you.

Suitable For

Patients who are typically recommended sentinel lymph node biopsy are those with uterine cancer who have undergone a hysterectomy. Specifically, the procedure may be advised for women who have had a less invasive form of hysterectomy, such as a robotic-assisted procedure. The decision to perform a sentinel lymph node biopsy may also depend on the individual patient’s risk factors and overall health status.

Timeline

Before the sentinel lymph node biopsy, the patient would have undergone a hysterectomy for uterine cancer. They may have had imaging tests to determine if the cancer has spread to nearby lymph nodes.

During the sentinel lymph node biopsy procedure, a small amount of radioactive material or dye is injected near the tumor site to help identify the sentinel lymph node, which is the first lymph node where cancer cells are most likely to spread. The surgeon then removes this node for analysis.

After the sentinel lymph node biopsy, the patient may experience some pain and swelling at the biopsy site. They may also have restrictions on physical activity for a short period of time. The sentinel lymph node is then sent to a pathologist for examination to determine if cancer cells are present. Depending on the results, further treatment may be recommended.

Overall, the use of sentinel lymph node biopsy in women with uterine cancer has increased over time, particularly in those who had a robotic-assisted hysterectomy. The procedure may offer benefits such as shorter hospital stays and lower costs compared to traditional lymphadenectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sentinel lymph node biopsy include:

  1. What is a sentinel lymph node biopsy and how does it differ from a traditional lymphadenectomy?
  2. Am I a candidate for a sentinel lymph node biopsy?
  3. What are the potential benefits and risks of having a sentinel lymph node biopsy?
  4. How accurate is the sentinel lymph node biopsy in detecting cancer spread compared to a traditional lymphadenectomy?
  5. Will the results of the biopsy impact my treatment plan?
  6. What is the recovery process like after a sentinel lymph node biopsy?
  7. How often do you perform sentinel lymph node biopsies and what is your experience with this procedure?
  8. Are there any alternatives to a sentinel lymph node biopsy that I should consider?
  9. Will my insurance cover the cost of a sentinel lymph node biopsy?
  10. Are there any long-term implications or side effects associated with having a sentinel lymph node biopsy?

Reference

Authors: Wright JD, Cham S, Chen L, Burke WM, Hou JY, Tergas AI, Desai V, Hu JC, Ananth CV, Neugut AI, Hershman DL. Journal: Am J Obstet Gynecol. 2017 Jun;216(6):594.e1-594.e13. doi: 10.1016/j.ajog.2017.02.021. Epub 2017 Feb 16. PMID: 28213057