Bilateral Negative Sentinel Nodes Accurately Predict Absence of Lymph Node Metastasis in Early Cervical Cancer: Results of the SENTICOL Study

Lécuru, Fabrice; Mathevet, Patrice; Querleu, Denis; Leblanc, Éric; Morice, Philippe; Daraı̈, Émile; Marret, H.; Magaud, Laurent; Gillaizeau, Florence; Châtellier, Gilles; Dargent, D

doi:10.1200/jco.2010.32.0432

Cited by 368 publications

(280 citation statements)

References 25 publications

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“…For the remaining studies, the full text was read. Finally, a total of 17 studies were included in the analysis, involving a total of 1,112 patients (5,6,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). The study selection process is summarized in Fig.…”

Section: Study Selection and Descriptionmentioning

confidence: 99%

Sentinel lymph node biopsy in cervical cancer: A meta-analysis

et al. 2013

Molecular and Clinical Oncology

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Abstract. Sentinel lymph node biopsy (SLNB) is used to determine the pathological status of the first lymph node receiving lymphatic drainage from the primary tumor. The diagnostic value of SLNB for the assessment of the nodal status in patients with cervical cancer has not been determined. Therefore, this meta-analysis was conducted to assess the diagnostic value of SLNB in cervical cancer. A search for related literature was performed using PubMed. Data were analyzed using a random effects model and a subgroup analysis was used to assess the diagnostic value of different practices during the process. A total of 17 studies involving a total of 1,112 patients were included in the analysis. The pooled sentinel lymph node (SLN) detection rate, sensitivity and negative predictive values were 92.2% [95% confidence interval (CI): 88.3-94.8%], 88.8% (95% CI: 85.1-91.7%) and 95.0% (95% CI: 92.8-96.6%), respectively. The subgroup analysis revealed that laparoscopy, tracer combination and immunohistochemistry were associated with a higher SLN detection rate. In conclusion, the SLNB in cervical cancer appears to be of diagnostic value, particularly the procedure with the combination of laparoscopy, combined tracers and immunohistochemistry. However, further studies are required to establish the clinical value of SLNB in cervical cancer.

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Section: Study Selection and Descriptionmentioning

confidence: 99%

Sentinel lymph node biopsy in cervical cancer: A meta-analysis

et al. 2013

Molecular and Clinical Oncology

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“…As a matter of fact, looking at the official international literature, the frequency of a correct SLN identification really varies from one approach used to another and from a working team to another. In this context of very heterogeneous data, referring to the French and American studies that report the best results, the chance of optimal SLN identification is not superior to 76.5% 13, 15. These results significantly impact the overall sensitivity of the procedure, as a failure in SLN mapping in one or both the hemipelvis leaves the “negative” side completely uninvestigated.…”

Section: Discussionmentioning

confidence: 98%

“…Despite large studies have demonstrated a good diagnostic performance of SLN biopsy in cervical cancer patients, with a NPV ranging from 94.3% to 98.2%, one of the main concerns about its full adoption is the relatively low detection rate of the technique 11, 13, 20, 21, 22. As a matter of fact, looking at the official international literature, the frequency of a correct SLN identification really varies from one approach used to another and from a working team to another.…”

Section: Discussionmentioning

confidence: 99%

“…The idea of using sentinel node biopsy is based on the fact that status of regional LNs could be accurately represented by the status of the SLN. However, regardless of the technique used, detection rate of SLN ranges from 92% to 97% of overall mapping to 70–79% of complete, bilateral, mapping 13, 14. In order to ensure the detection of all LNM, an algorithm that recommends side‐specific nodal dissection in case of failed SLN mapping and removal of all suspicious enlarged nodes was developed and introduced in international guidelines 15, 16.…”

Section: Introductionmentioning

confidence: 99%

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Beyond sentinel node algorithm. Toward a more tailored surgery for cervical cancer patients

et al. 2016

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Nowadays cervical cancer is frequently diagnosed at early stage. For these patients lymph node metastasis (LNM) is considered the most important prognostic factor. During the last decade many efforts have been made to reduce rate of complications associated with lymphadenectomy (LND). A great interest has arisen in sentinel lymph node (SLN) biopsy as a technique able to decrease number of LND performed and, at the same time, to assess lymph nodal status. High diagnostic performances have been reached thanks to SLN surgical algorithm. However, despite the efforts, about 25% of these patients undergo at least unilateral LND to meet NCCN recommendations. Data of women with International Federation of Gynecology and Obstetrics stage IA1‐IB1/IIA1 cervical carcinoma were retrospectively collected by six Italian institutions. All patients underwent complete preoperative staging workup and were primarily treated by radical hysterectomy and pelvic bilateral LND. A total of 368 patients with early‐stage cervical cancer were identified. Among them 333 (90.5%) showed no suspicious enlarged nodes at the preoperative magnetic resonance imaging (MRI). In this subset, tumor diameter ≥20 mm was the only independent predictor of LN status (P = 0.003). None of the 106 patients with negative MRI nodal assessment, with squamous and adenosquamous histotype and a tumor diameter less than 2 cm had LNM. Based on these results we propose a new modified SLN surgical algorithm that could safely reduce LND performed in patients with very low‐risk early‐stage cervical cancer.

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“…16 Other authors have demonstrated a 94% rate of detection of sentinel lymph nodes associated with sensitivity and negative predictive value of 100%, for tumors less than 2 cm. 17 The recent study SENTICOL 18 , in which SLB was carried out in a uniform manner by experienced surgeons, combining techniques that utilize blue dye and lymphoscintigraphy with technetium (Tc99), demonstrated a sensitivity of 92% and obtained ideal mapping in 75% of patients. These authors concluded that when utilizing the two techniques combined, a negative result in the sentinel lymph nodes on both sides indicates the absence of metastatic disease, with a negative predictive value of 98.2%.…”

Section: Lymph Nodesmentioning

confidence: 99%