Didactics-Sentinal mapping in Gynecolgical Cancers

Video Transcription

Video Summary

The video discusses the concept of sentinel node mapping in gynecologic cancers, specifically vulva, uterine, and cervical cancer. The concept of sentinel node mapping involves injecting a contrast agent near the tumor site to identify the first site of metastasis, or the sentinel lymph node, which can represent the status of the remaining lymph nodes. Different dyes are used depending on the type of cancer, such as indocyanine green (ICG) for endometrial cancer and isosulfan blue for vulva cancer. The lymph nodes obtained during mapping are subjected to H&E staining, and if positive, further ultra-staging is performed to determine the extent of metastasis. Sentinel node mapping has several benefits, including guiding adjuvant therapy and reducing surgical morbidities. The video also discusses key studies in each type of cancer, including the GLOIN-V study for vulva cancer, the GOG173 study for endometrial cancer, and the AGO study for cervical cancer. These studies demonstrate the effectiveness of sentinel node mapping in accurately detecting lymph node metastasis and guiding treatment decisions. While the video acknowledges that there may not be a significant improvement in survival with sentinel node mapping, it emphasizes the importance of accurately staging the lymph nodes and providing appropriate adjuvant therapy.

Keywords

sentinel node mapping

gynecologic cancers

contrast agent

metastasis

adjuvant therapy

surgical morbidities

lymph node metastasis