Prognostic outcome and complications of sentinel lymph node navigation surgery for early-stage cervical cancer

Yahata, Hideaki; Kobayashi, Hiroaki; Sonoda, Kenzo; Kodama, Kazuhisa; Yagi, Hiroshi; Yasunaga, Masafumi; Ohgami, Tatsuhiro; Onoyama, Ichiro; Kaneki, Eisuke; Okugawa, Kaoru; Baba, Shingo; Isoda, Takuro; Ohishi, Yoshihiro; Oda, Yoshinao; Kato, Kanefusa

doi:10.1007/s10147-018-1327-y

Cited by 34 publications

(27 citation statements)

References 22 publications

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“…Among methods of assessing the PLN status, SLNB is more suitable than imaging techniques 19 . Moreover, compared with PLND, SLNB reduces complications of PLND, 20 and no difference was observed in the recurrence‐free survival rates of PLND and SLNB in a prospective trial 21 . Therefore, SLNB may be used as an alternative to PLND to prevent unnecessary and harmful interventions.…”

Section: Discussionmentioning

confidence: 99%

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Qian

Huiqing

et al. 2020

BJOG

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Objective To evaluate the clinical diagnostic validity of carbon nanoparticle suspension (CNS) in sentinel lymph node biopsy (SLNB) for assessing lymphatic spread of early‐stage cervical cancer. Design A prospective study. Setting and population 356 cases. Methods We enrolled 356 stage Ia2‐IIa2 cervical cancer patients to undergo SLNB using CNS, followed by systematic pelvic lymphadenectomy. All lymph node specimens were assessed using conventional histopathologic ± pathologic ultrastaging analyses. Main outcome measures Sentinel lymph node detection rate (DR), clinical diagnostic validity and various related factors were analysed. Results CNS identified 1456 SLNs in 325 patients. The overall SLN DR was 91.29%. A significantly higher DR was found for patients with tumours <20 mm (97.75% versus 71.91%; P < 0.001). Two patients had false‐negative results. SLNB with CNS had sensitivity of 96.65%, false‐negative rate (FNR) of 4.35% and negative predictive value (NPV) of 99.29%. Importantly, sensitivity (100%), NPV (100%) and FNR (0%) were improved when testing the subgroup of patients with tumours <20 mm (267 cases). There were no observed differences in DR based on pathological type or grade, stage, depth of stromal invasion, surgical approach, menopausal status or prior treatment with chemotherapy (P > 0.05). Conclusions Sentinel lymph node biopsy with CNS results in favourable DR, sensitivity and NPV for women with early‐stage cervical cancer with small tumour sizes. SLNB with CNS is safe, feasible and relatively effective for guiding precise surgical treatment of early‐stage cervical cancer. Tweetable abstract Sentinel lymph node biopsy with carbon nanoparticle suspension is safe and feasible for early‐stage cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Qian

Huiqing

et al. 2020

BJOG

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“…However, the National Comprehensive Cancer Network (NCCN) guidelines did not make the same recommendation [11]. In clinical practice, some gynecologists are still used to perform systematic lymphadenectomy for patients with positive SLN identified on intraoperative assessment [12], whereas others directly exempt lymphadenectomy for all patients and plan chemoradiotherapy for those presenting positive SLN on final pathology. A recent international survey by the Gynecologic Cancer Intergroup clearly reflected these divergences in gynecologists' attitudes toward SLN biopsy [13].…”

Section: Introductionmentioning

confidence: 99%

Potential risks in sentinel lymph node biopsy for cervical cancer: a single-institution pilot study

Wan

Zhang

et al. 2020

World J Surg Onc

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Background: Sentinel lymph node (SLN) biopsy is an attractive technique that is widely performed in many oncological surgeries. However, the potential risks in SLN biopsy for cervical cancer remains largely unclear. Methods: Seventy-five patients with histologically confirmed cervical cancer were enrolled between May 2014 and June 2016. SLN biopsies were performed followed by pelvic lymphadenectomies and all resected nodes were labeled according to their anatomic areas. Only bilateral detections of SLNs were considered successful. Patients' clinicopathologic feature, performance of SLN detection, and distributions of lymph node metastases were analyzed. Results: Of the 75 enrolled patients, at least one SLN was detected in 69 (92.0%), including 33 in bilateral and 36 in unilateral. SLNs were most detected in the obturator area (52 of 69 patients, 75.4%) and 26 (37.7%) patients presented SLNs in more than one area of hemipelvis. Lymphovascular invasion was found to be the only factor that adversely influenced SLN detection, while the tumor diameter, growth type, histological grade, deep stromal invasion, and neoadjuvant chemotherapy showed no significant impacts. Patients with lymphovascular invasion showed a significantly higher rate to have unsuccessful detection (90.9% versus 41.5%, P < 0.001) and lymph node metastasis (40.9% versus 3.8%, P < 0.001) compared with those without. Nodal metastases were confirmed in 11 patients, of whom 9 (81.8%) had lymphovascular invasion and 7 (63.6%) had non-SLN metastasis. The most frequently involved SLNs were obturator nodes (9/11, 81.8%). In addition, the parametrial nodes also have a high rate to be positive (4/11, 36.4%), although they were relatively less identified as SLNs. Besides, 3 patients showed metastases in the laterals without SLN detected. Conclusions: In cervical cancer, lymphovascular invasion is a significant factor for unsuccessful SLN detection. The risk of having undetected metastasis is high when SLN is positive; therefore, further lymphadenectomy may be necessary for these patients.

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“…Nanoparticles (NPs) are very frequently studied as potential diagnostics, therapeutics or theranostics for especially cancer applications (to date over 30,000 articles according to Web of Science). For diagnostics, the clinically exploited nanoparticles in oncology are, e.g., 99m Tc-radiolabeled sulfur [ 1 , 2 ] or calcium phytate nanoparticles (to track functional liver reserve or sentinel lymph nodes after solid tumor resection) [ 3 , 4 ], for therapy, e.g., paclitaxel-loaded albumin nanoparticles are used as anticancer agents (Abraxane ® ) [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Head-To-Head Comparison of Biological Behavior of Biocompatible Polymers Poly(Ethylene Oxide), Poly(2-Ethyl-2-Oxazoline) and Poly[N-(2-Hydroxypropyl)Methacrylamide] as Coating Materials for Hydroxyapatite Nanoparticles in Animal Solid Tumor Model

et al. 2020

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Nanoparticles (NPs) represent an emerging platform for diagnosis and treatment of various diseases such as cancer, where they can take advantage of enhanced permeability and retention (EPR) effect for solid tumor accumulation. To improve their colloidal stability, prolong their blood circulation time and avoid premature entrapment into reticuloendothelial system, coating with hydrophilic biocompatible polymers is often essential. Most studies, however, employ just one type of coating polymer. The main purpose of this study is to head-to-head compare biological behavior of three leading polymers commonly used as “stealth” coating materials for biocompatibilization of NPs poly(ethylene oxide), poly(2-ethyl-2-oxazoline) and poly[N-(2-hydroxypropyl)methacrylamide] in an in vivo animal solid tumor model. We used radiolabeled biodegradable hydroxyapatite NPs as a model nanoparticle core within this study and we anchored the polymers to the NPs core by hydroxybisphosphonate end groups. The general suitability of polymers for coating of NPs intended for solid tumor accumulation is that poly(2-ethyl-2-oxazoline) and poly(ethylene oxide) gave comparably similar very good results, while poly[N-(2-hydroxypropyl)methacrylamide] was significantly worse. We did not observe a strong effect of molecular weight of the coating polymers on tumor and organ accumulation, blood circulation time, biodistribution and biodegradation of the NPs.

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Prognostic outcome and complications of sentinel lymph node navigation surgery for early-stage cervical cancer

Abstract: Using SNNS for early-stage cervical cancer is safe and effective and does not increase the recurrence rate. A future multicenter trial is warranted.

Cited by 34 publications

References 22 publications

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Potential risks in sentinel lymph node biopsy for cervical cancer: a single-institution pilot study

Head-To-Head Comparison of Biological Behavior of Biocompatible Polymers Poly(Ethylene Oxide), Poly(2-Ethyl-2-Oxazoline) and Poly[N-(2-Hydroxypropyl)Methacrylamide] as Coating Materials for Hydroxyapatite Nanoparticles in Animal Solid Tumor Model

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