Would you consider sentinel lymph nodes in a patient with a history of radiation for rectal cancer (no surgery) now with newly diagnosed endometrial cancer?
Do you utilize sentinel lymph node mapping for patients with endometrial cancer who have a history of prior pelvic radiation?
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I do not perform sentinel node biopsy for patients who have undergone radiation for rectal cancer. The radiation field for rectal cancer usually includes the tumor plus a 2-5 cm margin. The presacral nodes and internal iliac nodes may also be included. (Kye and Cho, PMID 25210685)
Radiation may also injure lymphatics and cause nodal fibrosis (Allam et al., PMID 32420295) which may render sentinel mapping inaccurate.
That being said, I don’t know of any formal statement that sentinel node biopsy for endometrial cancer is contraindicated in the setting of prior radiation for rectal cancer. But it seems like common sense that lymphatic drainage in the pelvis is affected by radiation.
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