Sentinel lymph node in endometrial cancer: A systematic review on laparoscopic detection

Endometrial cancer (EC) is the most frequent gynecological malignancy in developed countries, and accounts for 6-9% of female malignancies. The prevalence is growing in overweight individuals and those with medical comorbidities such as diabetes and hypertension. Nodal status is a key determinant of the outcome and there is a strong rationale incorporating sentinel lymph node (SLN) biopsy in the management of EC. We performed a systemic review concerning studies investigating the role of laparoscopic detection of SLN in early-stage EC. The detection rate and sensitivity of the laparoscopic approach in SLN ranged from 69.6% to 100% and 58.6% to 100%, respectively. The combination of dye and radiocolloid detection substances is the best method for SLN detection in EC. The use of pericervical injection and the laparoscopic approach increase the detection rate of SLNs, especially in the iliac lymph node groups. The hysteroscopy injection technique highlights the presence of isolated para-aortic lymph node metastasis. However, the precise method of SLN biopsy in EC needs to be determined further.