Lymph Node Mapping and Sentinel Node Detection in Patients With Cervical Carcinoma: A 2-Year Experience

Stefano, Andrea B. Di; Acquaviva, Giusi; Garozzo, G; Barbič, Matija; Cvjetičanin, Branko; Meglič, Leon; Kobal, Borut; Rakar, S

doi:10.1097/01.ogx.0000206322.51938.6d

Cited by 10 publications

(18 citation statements)

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“…The data in the literature on the diagnostic value of SLN frozen-section examination vary, with reported sensitivity ranging from 33 to 100%, depending on the technique used [14,15]. Martínez et al [16] investigated the accuracy of frozen SLN section in 94 patients with stage IA-IB1 cervical cancer who underwent SLN detection followed by full pelvic dissection.…”

Section: Discussionmentioning

confidence: 99%

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

et al. 2017

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Background and Objectives: Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis. Methods: We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned. Results: All patients could be evaluated for SLNs; a total of 610 SLNs were analyzed. Although the specificity of both imprint cytology and frozen-section examination was 100.0%, the sensitivity was only 58.6 and 65.5%, respectively. The diagnostic sensitivity was higher in 2-mm slices along the short axis than on bisection along the longitudinal axis. Imprint cytology correctly diagnosed 2 patients who had false-negative results on frozen section. The nature of the metastatic foci that caused an intraoperative false-negative diagnosis was either micrometastasis or isolated tumor cells. Conclusions: The accuracy of intraoperative SLN diagnosis requires improvement, especially when small metastatic foci are present.

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Section: Discussionmentioning

confidence: 99%

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

et al. 2017

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“…Nevertheless, these were good results in the different trials. Di Stefano et al 38 and Yuan et al 40 studied methylene blue in SLN identification for patients with cervical cancer using laparotomy approach for radical hysterectomy and pelvic lymphadenectomy, their results also had high SLN identification rate of 90% and 93.9%.…”

Section: Single Technique In Sln Detectionmentioning

confidence: 86%

“…They visualized the blue node stable in 30 minutes and never seen after 50 minutes as well as Di Stefano et al never displayed the SLN before 20 minutes and after 70 minutes of blue dye injection. 38 The authors concluded that the blue dye dosage and site of injection, the time between dye injection and the operative procedure, may be factors that affected the detection of SLN. By contrast, Altgassen and partners 39 compared 2 ml diluted isotonic solution to 10 ml and 4 ml of pure patent blue.…”

Section: Effect Of Process and Materials In Sln Detectionmentioning

confidence: 98%

Factors related to sentinel node identification in cervical cancer

Jarruwale

Huang

Benavides

et al. 2012

Gynecology and Minimally Invasive Therapy

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a b s t r a c tCervical cancer remains a common malignancy in women. Lymph node is one of the significant important prognostic factors. Until now, there is no reliable investigative study that can evaluate nodal status the same as the International Federation of Gynecology and Obstetrics (FIGO) clinical staging system. Radical hysterectomy and pelvic lymphadenectomy is still one option in the standard treatment of patients with early-stage cervical cancer that can reveal metastatic lymph node but which can also produce treatment-related morbidities and complications. Sentinel lymph node identification has become a valuable technique for nodal status assessment. If lymph node metastasis was identified early, then unnecessary invasive surgical operations and complications may be avoided. IntroductionThe third most common female malignancy is cervical cancer; 530,000 new cases were diagnosed in 2008 1 and 250,000 deaths from it occurred in 2005, approximately 80% of deaths happened in developing countries. 2 Cervical cancer is still the fifth leading cause of cancer death (9.1 per 100,000) of women in Taiwan. 3 Nodal status is the most significant negative prognostic factor of cervical cancer and may also reveal the lymphatic spreading. 4 Likely as radical hysterectomy accompanied with pelvic lymphadenectomy still have the role in early stage cervical cancer treatment. If the risk factors of the lymphatic metastasis were identified, surgery may be skipped to another appropriate modality primarily. 5 Even though significant morbidity possibly occurred if extensive surgical procedures were performed. According to operative disadvantages, many studies were progressed for decreasing those adverse effects. Basis of sentinel lymph node detectionSentinel lymph node (SLN) was defined as the first node in regional lymphatic basin that receives primary lymphatic drainage. 6,7 If SLN does not emerge, the remaining regional nodes should also be free of metastases. Thus SLN identification was an alternative resource for avoiding unnecessary lymphadenectomy and surgical interventions. The SLN concept is not only generated from many studies for nongynecologic tumors, such as penile cancer, 8 breast cancer, 9 and melanoma, 10,11 but it was also utilized for gynecologic malignancy treatment 12,13 thereafter. Nowadays, the practical lymphatic mapping methods use vital blue dye and lymphoscintigraphy techniques. 6,7,14 The modes for SLN identification are labeled as "hot" and/or "blue" as shown in Fig. 1. Types of materials and trial proceedings were selected dissimilarly. Materials used for detecting SLNThere are various reporting methods for SLN detection, e.g., vital blue dye and radioactive isotopes in single or a combined technique. 6,15 The three most commonly used vital dyes are isosulfan blue, patent blue violet, and methylene blue by injection intradermally 5e10 mm in depth around the primary cervical tumor, avoiding tumoral or intravascular infusion directly to avoidance of high background signal intensity that can decline S...

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“…For gynecology, successful application of sentinel node techniques in endometrial [52] cervical [53] and vulvar cancers [54] have been described. Urologic applications have included prostate [55] and bladder [56] cancers.…”

Section: Main Applications Of Lymphoscintigraphy In the Sentinel Lympmentioning

confidence: 99%

Lymphoscintigraphy and clinic

Mango¹,

Ventroni²,

Michelini³

2017

Res Rev Insights

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Lymphoedema is a clinically unusual picture characterized by slowing down or block of the lymphatic circulation of limb or limbs affected, with progressively worsening evolution and appearance of recurrent acute lymphangitis complications, responsible for a further increase in volume and consistency of edema. The diagnosis or early identification of lymphoedema as well as its predisposition, can be revealed by lymphoscintigraphy. The sentinel lymph node individuation and surgical removal can be considered to be pro-procedure standard for many type of cancers, and preoperative lymphoscintigraphy has been recommended to confirm the successful uptake and direction of migration of radiotracer into sentinel nodes during lymphatic mapping.

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Lymph Node Mapping and Sentinel Node Detection in Patients With Cervical Carcinoma: A 2-Year Experience

Cited by 10 publications

References 0 publications

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

Factors related to sentinel node identification in cervical cancer

Lymphoscintigraphy and clinic

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