Revisiting the effectiveness of a forgotten technique: the value of blue dye on sentinel lymph node biopsies of gynecological cancer

Sentinel lymph node biopsy with blue dye has been used extensively in the past for the evaluation of patients with gynecological cancer. While the technique has been negatively criticized as inaccurate in detecting an appropriate number of lymph nodes bilaterally, novel studies seem to suggest an acceptable detection rate that is directly attributed to the number of cases performed as well as the type of dye that is used. Taking into consideration the significant impact of comprehensive pelvic lymphadenectomy on the quality of life of these patients, it seems reasonable to suggest its use in the absence of appropriate economic resources, such as in low income countries. In the present study we summarize the available evidence concerning the diagnostic performance of the various techniques that are used in sentinel lymph node resection in gynecologic oncology, focusing on the potential benefits of blue dye in specific settings.