Sentinel lymph node biopsy can now be performed for endometrial cancer as well as cervical cancer.

What is lymph node metastasis?

Metastasis occurs when cancer spreads from the place where it first began (the primary tumor) to other parts of the body.
Broadly speaking, cancer spreads through two routes: blood flow and lymphatic flow.

When cancer cells enter the lymphatic system and travel to lymph nodes, where they multiply, this is called lymph node metastasis.

Cervical cancer and uterine cancer are diseases that are more likely to metastasize via the lymphatic system than via the bloodstream.

What is a sentinel lymph node?

They are also called "sentinel lymph nodes" or "sentinel lymph nodes." They are "the lymph nodes that cancer cells reach first through the lymphatic flow." Therefore, cancer metastasis to the lymph nodes occurs first in the sentinel lymph nodes.

Examining this sentinel lymph node during surgery to diagnose whether or not there is metastasis can have a significant impact on the surgical strategy.

Sentinel lymph node testing has already been widely adopted clinically for breast cancer, and several research results have already been produced in cervical cancer and endometrial cancer, demonstrating its usefulness.

What is the treatment that applies the concept of sentinel lymph nodes?

Our obstetrics and gynecology department has been conducting research into finding and removing lymph nodes called "sentinel lymph nodes" for cervical cancer, and has also become able to conduct research into uterine cancer.

The sentinel lymph node is the first lymph node to receive blood from the primary tumor, so if it can be found and examined in detail, even small lymph node metastases can be removed without being overlooked.

In addition, if there is no metastasis when the sentinel lymph node is examined, it is assumed that there is no metastasis to other lymph nodes. In the future, the goal is to be able to reduce the physical burden of surgery by not removing other lymph nodes if there is no metastasis to the sentinel lymph node.

At the current stage, sentinel lymph nodes are examined to check for metastasis in detail, but conventional lymph node dissection is still necessary. However, it is now possible to adjust the intensity of lymph node dissection, and by detecting small metastases during surgery that were previously undetectable, it is now possible to make decisions that have a major impact on treatment plans.

Currently, our hospital is the only one in the Kinki region that performs this test.