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Sentinel LYMPHO Node Mapping in Uterine Cancer on SPECT- CT an Experiment of the Nuclear Medicine Department Of Saint Antoine Hospital of Paris

The lymph node status is an important prognostic factor and a major criterion of decision uterine cancer’s treatment. Its evaluation by the sentinel lymph node technique has greatly improved support but requires a good understanding of the mechanisms of cancer spread. The objective of this study was to determine the different location sites of sentinel node in cancers of the cervix in the early stages of the classification of FIGO. The exploration was performed in 42 patients with a mean age of 38 years (standard deviation of 9 years), whose preoperative MRI showed no suspect lymph node. The most representative class was that between [30-40 [years. The Ib1 stage of FIGO classification was the most frequent with 64, 28%, Followed by IA1 stage with 21.1%. A combined analysis of planar and sectional image helped to recover 152 sentinel nodes. Pelvic location (internal iliac, external iliac, common iliac and sacred pre) was found in 87,5% against 12,5% extra pelvic location (aortic).Statistically significant associations were noted between different locations site: external iliac and common iliac (P = 0.002), external iliac and Aortic (P = 0.009), common iliac and Aortic (P = 0.0001).Among the sentinel nodes found on imaging, 81% were confirmed positive on histology. Sentinel lymph nodes of extra pelvic location were found histologically positive in 36.84% of cases against 24.8% in sentinel nodes pelvic location. The way of hypogastric dissemination was the most important (44%). Our results show that systematic lymphadenectomy realized in early stages are not always timely, and targeted analysis of nodes requires a use of sentinel lymph node technique with careful exploration of all nodal areas as well as a precise description of the topography of the ganglion. These results explain the deficiencies of treatment in systematic lymphadenectomy and show the value of a treatment adapted to a good mapping of the sentinel node. Keywords: cartography - cervical cancer- sentinel lymph node –SPECT/CT


Auteur(s) : O. Diop, B. Ndong, E. A.L. Bathily, W. Sow-Diop, G. Mbaye, L A D Diouf, P .M SY, A.R. Djiboune O. Ndoye, M. Mbodj, S.Seck-gassama, J-Y. Devaux
Année de publication : 2016
Revue : IJISET - International Journal of Innovative Science, Engineering & Technology
N° de volume : Vol. 3 Issue 9, September 2016
Type : Article
Mise en ligne par : DIOP Ousseynou