Feasibility of Sentinel Node Mapping in Ovarian Tumors: What Is the Evidence?
We have read with great interest the article of Nyberg et al,1 which was recently published in the International Journal of Gynecological Cancer. They reported the results of lymphatic mapping and sentinel node biopsy in 20 patients with ovarian tumors and concluded that sentinel node biopsy is feasible in these tumors. Nyberg et al are pioneers in sentinel node mapping of ovarian cancer and should be commended for their recent important study. Because evidence on feasibility and accuracy of lymphatic mapping for ovarian tumors is scarce, any addition to the literature should be welcomed.
Despite the utmost importance of the study by Nyberg et al, the authors did not cover the previous literature on sentinel node mapping in sufficient detail for comparison. Thus far, only 7 reports (from 5 research groups) on lymphatic mapping of ovarian tumors have been published.1–7 Summary of their results can be found in Table 1. Only 3 articles have investigated the feasibility of lymphatic mapping in a true clinical scenario (patients with ovarian tumors). Others actually performed lymphatic mapping on normal ovaries. It seems that despite excellent results thus far, we need far more studies with larger sample size to investigate the full aspect of sentinel node mapping in ovarian tumors. Injection site, mapping material, possible application of lymphoscintigraphy, and many other aspects of this technique should be clarified in future studies.