Background
Methods
Sentinel node mapping
Results
N | Age/tumor side/tumor size (cm) | Injection location | Final pathological results | Number and location of sentinel nodes on lymphoscintigraphy findings | Comments |
---|---|---|---|---|---|
1 | 28/left/12 × 8 | L | Benign follicular cyst | Two/para-aortic | – |
2 | 16/right/7 × 7 | C | Struma ovarii | Three/para-aortic | – |
3 | 54/left/20 × 25 | L | Serous cysadenofibroma | One/para-aortic | – |
4 | 35/left/10 × 9 | L | Mature teratoma | Two/para-aortic | – |
5 | 45/left/20 × 15 | C | Granulosa cell tumor | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Two hot sentinel nodes were identified during surgery in the para-aortic area. Sentinel nodes were not involved. No other lymph node involvement. |
6 | 42/right/15 × 10 | L | Mature teratoma with ovarian torsion | None | – |
7 | 51/left/10 × 10 | L | Benign papillary serous cyst with ovarian torsion | None | – |
8 | 17/left/7 × 7 | L | Benign serous cyst | Two/para-aortic | – |
9 | 26/left/10 × 5 | L | Benign luteal cyst | One/para-aortic | – |
10 | 32/right/8 × 10 | L | Mucinous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Three hot sentinel nodes were identified during surgery in the para-aortic area. None were involved. No lymph node involvement. |
11 | 52/right/12 × 15 | L | Borderline serous cystadenoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: One hot sentinel node was identified during surgery in the para-aortic area. None were involved. No lymph node involvement. |
12 | 59/right/6 × 8 | C | Mature teratoma | Two/para-aortic | – |
13 | 56/right/12 × 9 | C | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: No hot sentinel node was identified during surgery in the para-aortic area. No lymph node involvement. |
14 | 36/left/7 × 6 | L | Mature teratoma with ovarian torsion | None | – |
15 | 47/right/5 × 7 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Two hot sentinel nodes was identified during surgery in the para-aortic (one) and pelvic areas (one in the internal iliac area). None were involved. No lymph node involvement. |
16 | 42/right/12 × 13 | C | Thechoma | One/Para-aortic | – |
17 | 31/right/6 × 6 | L | Benign serous cyst | One/Para-aortic | – |
18 | 42/right/6 × 8 | C | Benign mucinous cystadenoma with ovarian torsion | None | – |
19 | 60/Bilateral/10 × 8;6 × 8 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Three hot sentinel nodes was identified during surgery in the para-aortic (two) and pelvic areas (one in the obturator). Both were involved. No other lymph node involvement. |
20 | 42/right/10 × 10 | C | Benign mucinous cystadenoma | None | – |
21 | 68/left/6 × 8 | L | Benign mucinous cystadenoma | One/Para-aortic | – |
22 | 40/left/6 × 8 | L | Benign mucinous cystadenoma | One/Para-aortic | – |
23 | 26/left/6 × 5 | C | Granulosa cell tumor | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: The hot sentinel node was identified during surgery in the para-aortic area. Sentinel node was not involved. No other lymph node involvement. |
24 | 45/left/7 × 6 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Two hot sentinel nodes were identified during surgery in the para-aortic (one) and external iliac (one) areas. Sentinel nodes were not involved. No other lymph node involvement. |
25 | 22/right/10 × 11 | L | Benign serous cyst | One/Para-aortic | – |
26 | 57/right/8 × 9 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: The hot sentinel node was identified during surgery in the para-aortic area. Sentinel node was not involved. No other lymph node involvement. |
27 | 43/Bilateral/11 × 12;10 × 6 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: The hot sentinel nodes were identified during surgery in the para-aortic (two sentinel nodes) and pelvic areas (right common iliac). None were involved. No other lymph node involvement. |
28 | 36/right/11 × 10 | L | Benign serous cyst | One/Para-aortic | – |
29 | 35/Bilateral/10 × 10;10 × 7 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Two hot (and blue) sentinel nodes were identified during surgery in the para-aortic area. One sentinel node was pathologically involved. No other lymph node involvement. |
30 | 50/right/7 × 8 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: The hot (and blue) sentinel node was identified during surgery in the pelvic area (external iliac). Sentinel node was not involved. No other lymph node involvement. |
31 | 43/Right/10 × 10 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: The hot (and blue) sentinel node was identified during surgery in the pelvic area (external iliac). Sentinel node was not involved. No other lymph node involvement. |
32 | 36/Right/10 × 12 | L | Benign mucinous cystadenoma | One/Para-aortic | – |
33 | 35/Bilateral/10 × 8;8 × 8 | L | Papillary serous adenocarcinoma | No remaining activity in the pelvis and abdomen | TAH + BSO + APAL: Two hot (and blue) sentinel nodes were identified during surgery in the para-aortic area. One of the sentinel nodes was involved. One non-sentinel node in the para-aortic was also involved. |
34 | 45/Left/7 × 7 | C | Benign serous cyst | None | – |
35 | 37/Left/8 × 8 | C | Benign serous cyst | None | – |
Discussion
First author/year | Included patients | Mapping material | Injection site | Main results |
---|---|---|---|---|
Kleppe/2014 | 21 patients diagnosed with a pelvic mass suggestive of a malignant ovarian tumor | Blue dye/Radiotracer | On the dorsal and ventral side of the proper ovarian ligament and the suspensory ligament, close to the ovary and just underneath the peritoneum | Al least one sentinel node could be identified in all patients (100 % detection rate). Para-aortic region only in 67 %, pelvic region only in 9 %, and in both in 24 %. No false negative case |
Negishi/2004 | 11 women with endometrial or fallopian tube tumors | Activated Charcoal | Into the unilateral cortex of the ovary | Sentinel node could be identified in all patients: para-aortic in all patients, common iliac node in three, and external iliac in one |
Nyberg/2011 | 16 patients with high-risk uterine cancer and normal postmenopausal ovaries | Blue dye/Radiotracer | Slow injection near the hilum of one ovary | Sentinel node could be identified in 15 patients (93.75 % detection rate). All were located in the para-aortic area. |
Vanneaville/1991 | 14 patient who were investigated by laparoscopy, either for ablation of a benign ovarian cyst or for tubal ligation | Radiotracer | Injection into the mesovarium of the normal ovaries during laparoscopy. | Lymphatic drainage could be discerned in 12 patients. Isolated para-aortic sentinel nodes in 4, combined pelvic/para-aortic sentinel nodes in 8. |
Lymphatic drainage was investigated by lymphoscintigraphy 4–6 h post-injection. | Isolated para-aortic drainage was more prominent in the post-menopausal (75 %) as compared to the pre-menopausal patients (12.5 %). | |||
The current study | 35 patients with ovarian tumors | Radiotracer | Sub-cortical in 11 and sub-peritoneal (ovarian and suspensory ligaments) in 24 | Detection rate of 40 % in the sub-cortical and 84 % in the sub-peritoneal group. Sentinel nodes were identified in 21 patient in the para-aortic area only and in 4 in the pelvic/para-aortic area. No false negative case was identified |