Lymphatic Mapping and Sentinel Node Identification in Patients With Cervix Cancer Undergoing Radical Hysterectomy and Pelvic Lymphadenectomy

Levenback, Charles; Coleman, Robert L.; Burke, Thomas W.; Lin, Wanrun; Erdman, William A.; Deavers, Michael T.; Delpassand, Ebrahim S.

doi:10.1200/jco.20.3.688

Cited by 194 publications

(116 citation statements)

References 13 publications

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“…Obturator lymph nodes are most likely to be involved in metastatic disease, followed by external iliac, common iliac, and parametrial lymph nodes [51]. Skip metastases to paraaortic lymph nodes are rarely seen and account for Ͻ1% of cases [52,53]. The SLN in cervical cancer is situated in the obturator region in 43% of cases and in the external iliac region in 45%-84% of cases [54,55].…”

Section: Lymphatic Drainage Of the Female Genital Tractmentioning

confidence: 99%

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

et al. 2009

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The treatment of gynecologic malignancies can include surgery, systemic therapy, and radiation. Depending on the primary site of disease and the extent of the disease, these treatment strategies are applied alone or in combination.Trends over the past few decades have concentrated on performing more comprehensive staging procedures for a large percentage of patients with gynecologic malignancies. The surgical techniques available for comprehensive staging have facilitated a greater understanding of stage and prognosis overall, and better tailoring of postsurgical treatment.One such technique is regional lymphadenectomy. Although the role of regional lymphadenectomy as a therapeutic procedure in some gynecologic cancers is debated and challenged (regional lymphadenectomy and multimodality therapy increases adverse side effects and long-term sequelae without proven survival benefit), there is no controversy regarding the staging and prognostic benefit of the evaluation of regional lymph nodes. The sentinel lymph node (SLN) concept was successfully introduced in melanoma. It has since become the standard of care in breast cancer and has had a significant impact on postoperative morbidity for a large percentage of breast cancer patients. Interest in using SLN techniques in gynecologic cancers was thus a natural progression. In light of the growing body of evidence in the literature opposing the therapeutic benefit of systematic lymphadenectomy, the SLN concept will continue to play an important role in the treatment of gynecologic malignancies. This technique can provide accurate staging information in some gynecologic cancers. Increased use of this technique could potentially impact the quality of life of gynecologic cancer survivors while still providing important staging information without compromising oncologic safety.In this review, we examine the body of literature related to gynecologic cancer malignancies and SLN biopsy. The Oncologist 2009;14:695-705

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Section: Lymphatic Drainage Of the Female Genital Tractmentioning

confidence: 99%

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

et al. 2009

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“…Also promising is the use of hypoxia tracers in PET imaging [56,57]. Because hypoxia is an important prognostic factor in cervical cancers, the use of 18 F-FMISO ( 18 F-fluoromisonidazole) or 60 Cu-ATSM [ 60 Cu-diacetyl-bis (N 4 -metylthiosemicarbazone)] as hypoxia tracers may give the clinicians determining information on tumour components [58]. These tracers also may be particularly useful for the initial assessment of tumour responsiveness to treatment, knowing that hypoxic cells are rather resistant to radiotherapy and chemotherapy [59].…”

Section: Perspectivesmentioning

confidence: 99%

“…These tracers also may be particularly useful for the initial assessment of tumour responsiveness to treatment, knowing that hypoxic cells are rather resistant to radiotherapy and chemotherapy [59]. On the other hand, the validation of the sentinel node concept in early stage cervical cancers along with the molecular analysis of the sentinel lymph nodes (SLN) may grant new perspectives for the selective evaluation of regional nodal status [60,61,62]. Accordingly, most women with early stage disease and negative SLN will be spared the morbidity resulting from unnecessary complete lymph node dissections.…”

Section: Perspectivesmentioning

confidence: 99%

Whole-body 18FDG PET plus pelvic MRI in the pre-treatment assessment of cervical cancers: an alternative to the FIGO clinical staging

Belhocine

2004

Gynecol Surg

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Growing evidence indicates that whole-body 18 F-fluorodeoxyglucose positron emission tomography (wb-18 FDG PET) plus pelvic magnetic resonance imaging (pMRI) may significantly improve the pre-treatment staging of primary cervical cancers. Such a combined protocol provides complementary insights into primary tumour delineation, loco-regional involvement and distant spread. As such, pMRI appears particularly reliable for the accurate measurement of tumour size, the detection of parametrial invasion and, even more so, for its exclusion. So far, wb-18 FDG PET yields unique information about extra-pelvic nodal and visceral tumour status. Of note, however, is the limitation of both imaging techniques for the detection of microscopic pelvic lymph node metastases, especially in early stage disease. Promising data also highlight the prognostic value of 18 FDG uptake as a marker of disease aggressiveness and of tumour resistance to treatment. The recent development of combined PET-CT scans as well as the validation of the sentinel node concept in gynaecological malignancies may grant new perspectives for optimal management of cervical cancers in the pre-treatment setting.

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“…This situation is clearly different from other viscera, such as the lung and oesophagus [20], mammary gland [26] and stomach [16,23]. Thus, application of sentinel node biopsy for carcinomas of the uterus [11,12] appeared to precede descriptions of normal adult anatomy of the lymphatic drainage routes. Likewise, to our knowledge, no or few studies have demonstrated the LVs around the normal uterus using D2-40 immunohistochemistry, in contrast to the extensive accumulation of knowledge of D2-40-positive LVs in other normal viscera (e.g., oesophagus [34], prostate [6], kidney [9] and others [7]).…”

Section: Introductionmentioning

confidence: 99%

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

Sasaki

Jin

Liu³

et al. 2016

Folia Morphol

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Lymphatic Mapping and Sentinel Node Identification in Patients With Cervix Cancer Undergoing Radical Hysterectomy and Pelvic Lymphadenectomy

Abstract: Preoperative lymphoscintigraphy and intraoperative lymphatic mapping were highly successful at identifying sentinel nodes in patients undergoing radical hysterectomy.

Cited by 194 publications

References 13 publications

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

Whole-body 18FDG PET plus pelvic MRI in the pre-treatment assessment of cervical cancers: an alternative to the FIGO clinical staging

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

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