New technique to detect sentinel node in ovarian cancer

A new detection technique – injecting tracers into ovarian ligaments – helps to carry out a sentinel lymph node procedure in ovarian cancer. This leads to greater accuracy in detecting lymph node metastases and also leads to fewer side effects for patients. These were the results of the PhD study carried out by Marjolein Kleppe, who will obtain her PhD from Maastricht University on 15 December. If this technique proves reliable, approximately 275 to 300 patients will benefit from it in the future.

At present, ten or more lymph nodes are surgically removed to test for lymph node metastases. However, even then lymph nodes can be missed because this area contains far more lymph nodes than other areas of the body (up to 250). The new detection technique – never before used with ovarian cancer – can help to detect the sentinel node, which is the first node in which metastases develop. A sentinel node biopsy aims to isolate this lymph node and determine with as much accuracy as possible whether any metastases are present in the surrounding lymph nodes. During surgery, the doctor injects a tracer to identify the sentinel node(s) in the two ovarian ligaments.

Further research
'The initial results are good, but more research is needed,' says Marjolein Kleppe. 'A national follow-up study will assess the reliability of this technique. When additional research proves that a new technique for detecting the sentinel node(s) is just as reliable for ovarian cancer as it is for breast cancer, identifying lymph node metastases will also become more reliable and produce fewer side effects, such as fluid retention in the legs.'

Presence and absence of metastases
Marjolein Kleppe chose this study to prevent too many lymph nodes from being removed and to determine whether this technique is reliable enough to identify potential metastases. If no metastases are found, surgery will be sufficient. If metastases are detected, the patient will also have to be treated with chemotherapy.

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