So first, I have no conflicts of interest to disclose. So we will talk about four points in today with endometrial cancer, senitine lymph nodes, and why the senitine lymph nodes actuate lymphadenitis in the early stage of endometrial cancer, and the last point is the dyes. So first of all, the endometrial cancer is a global cancer that is talked about worldwide. Endometrial cancer is the sixth most common malignancy in women. There were more than 417,000 new cases of endometrial cancer in the 2020s. And also in Vietnam, endometrial cancer is also the sixth most common cancer in women, and there were 5,300 new cases of endometrial cancer in 2020s. Because endometrial cancer typically is a diagnosis in the early stage, so the women with this diagnosis usually do very well, and the five-year overall survival of the early stage endometrial cancer is over 90%, and in the early stage disease, the standard treatment is so great. The complex surgical stagings for the endometrial cancer include the total hysterectomy, bilateral centroidal operatomy, and lymph node assessment. Removal of the lymph node alone has not been thought to be the therapy in and of itself, but it is important after determining both prognosis and post-operating or adjuvant treatment. So the principles of the senitineal lymph node mapping. The senitineal lymph node mapping is an approach to the lymph node assessment that's allowed to remove fewer lymph nodes. If the senitineal lymph node mapping, you ingest a tracer, either the titanium or the dye into the organs in order to determine the first lymph node running that organ. The first lymph node that shows the tracer will be the first lymph node that the cancer will typically go to. This is the pioneer in the melanoma and breast cancer, but it is now used in the other solid tumor types. In the gynecological cancer, it's used in the vulva cervical and endometrial cancer. Besides that, the toxics of lymphadenatamines are the intramorbility, such as vascular nerve and increase the blood stress. So we got the GOG 33, the 30 prognosis is evaluated 621 patients in the clinical stage of endometrial cancer. All the patients underwent the standard staging procedures with TSA, ESBSO and collect pelvic washing and selecting pelvic and parietal lymph node assessment. And you can see the results in the table here. With the patient with a low risk disease, in fact, in the grade one tumor with the endometrial involved, and no intra-disease, no pelvic and parietal lymph node metastasis. And those of the moderate risk disease, the device is under 15% myometrial invase and no intra-peritoneum disease has 3% from 3% to 6% incidence of the pelvis lymph nodes and 2% incidence of the parietal lymph node involvement. The high risk disease device is to classify myometrial invasions and intra-peritoneum disease. Those myome invasions have 18% and 15% incidence of the pelvis and parietal lymph node metastasis. And the patient with the intra-peritoneum disease has only under 15% myome involved, has a risk of 33% risk of the pelvis lymph node metastasis and 8% risk of positive parietal lymph nodes. The patient is both of the high risk, herpes, hyperhidroids, with 16% pelvic lymph node metastasis and 30% parietal lymph node involvement. So, the question is whether senescent lymph nodes are attenuated to the lymphadenectomy or not. In the two last protested trials, the FIRE trial and SENTI-ENDO trial, it shows that senescent lymph node detection improves the detection of the lymph node metastasis when compared with a full lymph node detection. It also decreases the risk of complications, increase the risk of lymphatic mass, morosa, nodal status, allow to the tolerance and avoidance of the adjuvant therapy. So, we have a feature of the FIRE trial comparing the senescent lymph node metastasis to the lymphadenectomy endometrial cancer. In this trial with 314 patients, we got a pelvis lymphadenectomy with 100% and the successful mapping of the senescent lymph node is just 18-16% and bilateral mapping is 15-20%. And the isolated parietal lymph node senescent lymph node detection is just under 1%. So, the outcome of the FIRE trial with the senescent lymph node is 1970% and the negative predict value is 99%. So, the isolated parietal lymph node with negative senescent lymph node in just 3 patients is under 1%. And also, the same result with the senescent lymph node endotrials with the overall detection strength is 18-9% with the parietal lymph node is 5%. And the senescent lymph node with 18-40% negative predict value is 97%. And the disease of pre-survival is 50 months with 18-40%. And we also have another trial from the malignant doctors with a senescent lymph node. We got a detection rate is 81% and with the senescent lymph node is 89% and the post-negative rate is just 1.9%. The negative predict is 99%. So, it's a beautiful result from the three trials for improving the senescent lymph node electrolytes with a good lymphadenation midisection. So, the outcome from the trials with 3-year DFS is 94% and 93% in the MAISIO trial and MSK trial. So, the summary, we have the senescent lymph node in the endometrial cancer is found to be safe and effective of the lymph node assessment in any endometrial cancer. It also decreases the risk of complications, includes a 3-degree risk of lymphedema. And the risk is very significant. The risk of lymphedema, it boosts lymph node dissection approximately 18%. And in the senescent lymph node dissection, it's not only 1%. The senescent lymph node masking in the endometrial cancer is typically performed with either a blue dye or endocaine sprains or ICDs. But the use of the ICD requires the ability to use a near-infrared machine. So, this is a blade board through the testable equipment that can be used in open laboratory or robotic case. So, the blue dye was the most common dye used in identifying the senescent lymph node back to the 2010s ago. You can see a lot of trials from back to the 2010s. Yes, you use the blue dyes. But now, the events of the increase except near-infrared of the fluorescence imaging for the laparoscopic, robotic, and open-platform ICDs has become increasingly popular. It has been sold that have equivalent and better detected traits in the senescent lymph nodes and uterine cancer. In the last video, I talked about the comparison with the ICDs and the blue dyes. You can see the ICD is a more detected trait of the senescent lymph nodes than the blue dyes. And so, we summarize the senescent lymph nodes is so safe and effective of the lymph node detection in the endometrial cancer. And the senescent lymph nodes improve the detection of the lymph node metastasis compared with the full lymph node detection. And the ICDs is preferred than the blue dyes and penicillin for the senescent lymph nodes in the endometrial cancer. Thank you.

endometrial cancer

sentinel lymph node mapping

prognosis

surgical staging procedures

sentinel lymph node detection