Frozen Section to Detect Empty Nodes and Improve the Accuracy of the Sentinel Lymph Node Biopsy in Endometrial Cancer

Excerpt

Sentinel lymph node (SLN) biopsy, identified after cervical injection of indocyanine green, has been proposed as an alternative to pelvic lymphadenectomy to reduce morbidity, operative time, and lymphatic-related complications for patients undergoing surgery for apparent staging of early-stage endometrial cancer.1‐3 By identifying the presence or absence of lymph node metastasis at final pathology, SLN biopsy potentially reduces the need for intraoperative frozen section (FS). However, as recently reported by a single-institution case report, approximately 7% of all SLN biopsies do not show any lymph node at final pathology,4 actually representing what we called the “empty node” (EN). In our study, we estimated the rate of EN identified at FS in a large series of SLN biopsies for endometrial cancer staging and sought to determine the impact at a national level of routinely performing FS in the SLN removed. …