Photo by Ana Thatcher
First Gold Coast-based gynaecological
oncologist dedicated to prevention,
diagnosis, and treatment of all types
and stages of gynaecological cancer.
Associate Professor Marcelo Nascimento
Gynaecological Oncologist
Laparoscopic Gynaecologic Surgeon
P: (07) 5564 5110
E: reception@drnascimento.com.au
W: DrNascimento.com.au
Pindara Specialist Suites, Suite 504, 29 Carrara Street, Benowa
Selective removal of sentinel lymph nodes will obtain
staging information while minimising patient toxicity.
When compared to a complete pelvic lymphadenectomy,
sentinel lymph node biopsy minimises not only immediate
intraoperative, but also long term risks for patients, and
operative time. One of the greater benefits to patients
is that this technique will radically decrease the risk of
lower limb lymphoedema (a painful swelling condition), a
common post-operative condition resulting from full pelvic
lymphadenectomy, well recognised as very difficult to treat.
Recent results also suggest that the sentinel node biopsy
might be even better than traditional complete pelvic
lymphadenectomy due to a more detailed lymph node
examination by the pathologist (called ultra-staging), a
higher chance that the sentinel lymph node will have disease
(because it is selectively targeted), and that this technique
may identify positive lymph nodes that are located outside of
traditional surgical boundaries (2).
I have been offering this revolutionary technique to my
patients diagnosed with early stage uterine tumours. They must
be appropriately selected and counselled. Currently available
techniques at Pindara Hospital include ICG and blue dye
and either of these methods will be utilised as available and
indicated. As is my standard practice all patients undergoing
this technique will have their condition recorded and reported
to the Queensland Gynaecological Cancer Quality Assurance
Committee, which I am an active member of.
I am obviously very excited with this new important step
in the treatment of gynaecological cancers and have been
regularly using the technique with success in my patients.
Further well designed studies will be soon published, and we
will be exploring feasibility and safety of sentinel lymph node
biopsy in other gynaecological cancers.
1 How J, Gauthier C, Abitbol J, Lau S, Salvador S, Gotlieb R, et al. Impact of sentinel
lymph node mapping on recurrence patterns in endometrial cancer. Gynecol Oncol.
2017;144(3):503-9.
2 Rossi EC, Kowalski LD, Scalici J, Cantrell L, Schuler K, Hanna RK, et al. A comparison
of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging
(FIRES trial): a multicentre, prospective, cohort study. Lancet Oncol. 2017;18(3):384-92.
3 Kimmig R, Buderath P, Mach P, Rusch P, Aktas B. Surgical treatment of early ovarian
cancer with compartmental resection of regional lymphatic network and indocyanine-green-
guided targeted compartmental lymphadenectomy (TCL, paraaortic part). J
Gynecol Oncol. 2017;28(3):e41.
4 Salvo G, Ramirez PT, Levenback CF, Munsell MF, Euscher ED, Soliman PT, et al. Sensitivity
and negative predictive value for sentinel lymph node biopsy in women with early-stage
cervical cancer. Gynecol Oncol. 2017;145(1):96-101.
5 de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, et al. Adjuvant
chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer
(PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3
trial. Lancet Oncol. 2018.
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