A Prospective Single-Center Study of Sentinel Lymph Node Detection in Cervical Carcinoma: Is There a Place in Clinical Practice?

Abstract

Sentinel lymph node detection is an accurate and safe method in the assessment of nodal status in early cervical carcinoma.

Location of Sentinel Lymph Node in Cervical Carcinoma and Factors Associated With Unilateral Detection

“…In our study, the majority of SLNs were located in the external iliac (38.6%), obturator (25.3%), and internal iliac regions (23.6%), which confirm the distribution of SLNs described by previous studies. 10,12,26,29 Distributions for the common iliac 11,28 and obturator regions 10,26,30 were similar to those reported by other studies. The detection of SLNs in the para-aortic region was low as previously reported (1.5%Y3.5%) in the SENTICOL study 4 and other studies.…”

“…Few studies have reported the SLN locations by different methods of detection (SPECT/CT scan, gamma probe, and blue dye). 4,11,12,27,28 These studies describe overall SLN locations in different regions of the pelvis, but not all commented on laterality.…”

“…12 If no metastasis was identified in this initial section, then ultrastaging was performed. 12,25 According to TNM criteria, metastatic disease was classified as macrometastatic (92 mm), micrometastatic (0.2Y2 mm), or isolated tumor cells (G0.2 mm). Non-SLNs underwent routine processing and paraffin embedding with 1 hematoxylin-eosinYstained slide of 3-Km thickness produced per node.…”

“…11,12,15Y20 The negative predictive value has been reported to be 97% to 100%. 4,12,15,17,21Y24 Several studies have described the anatomical location of the SLN in the pelvis in cervical cancer 4,10Y12 but not separately for each hemipelvis, and only a few have examined the potential factors associated with unilateral detection. This study reports the intraoperative anatomical SLN locations detected separately for each hemipelvis and examines the factors affecting bilateral detection.…”

Sentinel Lymph Node Mapping in the Management of Cervical Cancer

“…For example, presacral SLNs are less often diagnosed during laparoscopic surgery. This observation may be explained in terms of technical diffi culties and that some authors classify the presacral lymph nodes as belonging to the paraaortal [ 35 ] or internal iliac area [ 18 ]. Paraaortal lymph nodes were often detected during the 2-day protocols, which used ultra-small particles (<100 nm).…”