Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging

Balaya, Vincent; Guani, Benedetta; Benoit, Louise; Bonsang-Kitzis, Hélène; Ngô, Charlotte; Frère-Belda, M A Le; Mathevet, Patrice; Lécuru, Fabrice

doi:10.1016/j.ygyno.2020.05.043

Cited by 26 publications

(7 citation statements)

References 44 publications

(84 reference statements)

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“…Node status may be known intraoperatively, and enhances the avoidance of inappropriate radical procedure instead of referring patients to concomitant chemoradiotherapy [ 7 ]. However, the clinical value of frozen section analysis remains questionable due to the high rate of false-negative results and requires a high level of expertise for the pathologists [ 16 ]. Another pitfall is SLN detection failure, which occurs bilaterally in 3.7–5.9% of cases and unilaterally in less than 15% of cases [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Balaya

Guani

Mereaux

et al. 2021

Cancers

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Background: The prognosis of patients with cervical cancer is significantly worsened in case of lymph node involvement. The goal of this study was to determine whether pathologic features in conization specimens can predict the sentinel lymph node (SLN) status in early-stage cervical cancer. Methods: An ancillary analysis of two prospective multicentric database on SLN biopsy for cervical cancer (SENTICOL I and II) was carried out. Patients with IA to IB2 2018 FIGO stage, who underwent preoperative conization before SLN biopsy were included. Results: Between January 2005 and July 2012, 161 patients from 25 French centers fulfilled the inclusion criteria. Macrometastases, micrometastases and Isolated tumor cells (ITCs) were found in 4 (2.5%), 6 (3.7%) and 5 (3.1%) patients respectively. Compared to negative SLN patients, patients with micrometastatic and macrometastatic SLN were more likely to have lymphovascular space invasion (LVSI) (60% vs. 29.5%, p = 0.04) and deep stromal invasion (DSI) ≥ 10 mm (50% vs. 17.8%, p = 0.04). Among the 93 patients with DSI < 10 mm and absence of LVSI on conization specimens, three patients (3.2%) had ITCs and only one (1.1%) had micrometastases. Conclusions: Patients with DSI < 10 mm and no LVSI in conization specimens had lower risk of micro- and macrometastatic SLN. In this subpopulation, full node dissection may be questionable in case of SLN unilateral detection.

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Section: Introductionmentioning

confidence: 99%

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Balaya

Guani

Mereaux

et al. 2021

Cancers

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“…In the process of rapid freezing, various antigenic activities and enzymes can be well preserved, especially organic solvents and those with poor tolerance to temperature, which reduces the variation in tissue structure and improves the accuracy of testing. At present, IFSE is widely used in breast, lung, uterine, thyroid, and other tissues, and provides a reliable basis for pathological diagnosis (12)(13)(14)(15). Hence, IFSE results should be used to guide the surgical method of prostate nodules, such as that of breast nodules, to avoid patient suffering caused by multiple surgeries and to reduce the cost of treatment.…”

Section: Discussionmentioning

confidence: 99%

The application of intraoperative frozen section examination in multiparametric magnetic resonance imaging/transrectal ultrasound fusion prostate biopsy during a major pandemic

Ding¹,

Luan²,

Zhu³

et al. 2022

Quant Imaging Med Surg

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Background: To investigate the value of intraoperative frozen section examination (IFSE) in multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion prostate biopsy in a major pandemic.Methods: A total of 35 patients were prospectively enrolled in our hospital from March 2020 to January 2021. The mpMRI/TRUS fusion system was used to perform a targeted biopsy, and the collected specimens were examined by IFSE (Observation Group 1). Then, a targeted biopsy was performed again for routine pathological examination (Observation Group 2). Finally, a systemic biopsy was performed, and the obtained specimens were routinely examined (Control Group). The positive rate, single core positive rate, Gleason score, and time to obtain pathological reports were compared between the groups.Results: The positive rate was 48.6% (17/35) in the control group, 48.6% (17/35) in Observation Group 1, and 51.4% (18/35) in Observation Group 2, showing no significant difference (P>0.05). The single core positive rates were 17.8%, 44.6%, and 47.1% in the Control Group, Observation Group 1, and Observation Group 2, respectively. Observation Group 1 and Observation Group 2 were significantly different from the Control Group (P<0.001). No participants in Observation Group 1 had increased or decreased Gleason scores compared with those in Observation Group 2. The time to obtain the pathological report was 0.025±0.014 days and 4.216±1.073 days for Observation Group 1 and Observation Group 2, respectively, showing a significant difference (P<0.001).Conclusions: This study showed that IFSE can not only rapidly obtain the pathological report of an mpMRI/TRUS biopsy, but can also ensure the accuracy of the pathological diagnosis.

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“…In a Canadian study with 211 patients in total, micrometastasis remained unidentified in > 40 % of biopsies analysed intraoperatively [46]. In a joint analysis of the French SENTICOL-1 and SENTICOL-2 studies (n = 313) the sensitivity of intraoperative frozen section analysis was only 42 % [48]. Tissue that was used for frozen sections also contains a lot of artefacts and is no longer available for further definitive pathological examination [24].…”

Section: Methodsmentioning

confidence: 99%

Status of Sentinel Lymph Node Biopsy in Vulvar and Cervical Cancer

Waldschmidt

Jung

Juhasz-Böss

2020

Geburtshilfe Frauenheilkd

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Assessment of lymphatic metastasis is an essential component of solid tumour staging. Sentinel lymph node (SLN) biopsy is a minimally invasive procedure that allows regional lymph node involvement by tumour to be estimated by selectively examining the sentinel lymph node while minimising the morbidity of systematic lymph node dissection. Within the group of genital cancers, the diagnostic value of SLN biopsy is rated differently. For selected patients with early-stage vulvar cancer (unifocal primary tumour < 4 cm, clinically negative inguinal lymph nodes) the SLN technique is already an established procedure in the guidelines of the German Society for Gynaecology and Obstetrics (DGGG)/German Cancer Society (DKG) and the recommendations of the European Society of Gynaecological Oncology (ESGO). For cervical cancer, SLN biopsy has not yet been sufficiently standardised but can be considered for patients without risk factors with a primary tumour size < 2 cm. The SLN is identified by combined use of radioactive 99mtechnetium nanocolloid and patent blue. The use of indocyanine green offers an alternative for SLN identification with few side effects. Recent studies aim to increase the diagnostic reliability of intraoperative frozen section analysis as this continues to show limited sensitivity in both vulvar and cervical cancer. The rate of detection of micrometastases can be increased by additional ultrastaging, the prognostic significance of which for both diseases is still unclear. The prognostic value of SLN biopsy compared with systematic lymph node dissection is being investigated in current studies (GROINSS-V-II for vulvar cancer and SENTIX-, SENTICOL-3 for cervical cancer). For this review article, a guideline-based literature search was performed in the National Library of Medicine (PubMed/MEDLINE) database with a particular focus on recent cohort studies and conference contributions.

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Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging

Cited by 26 publications

References 44 publications

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

Can Conization Specimens Predict Sentinel Lymph Node Status in Early-Stage Cervical Cancer? A SENTICOL Group Study

The application of intraoperative frozen section examination in multiparametric magnetic resonance imaging/transrectal ultrasound fusion prostate biopsy during a major pandemic

Status of Sentinel Lymph Node Biopsy in Vulvar and Cervical Cancer

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