Sentinel Lymph Node Biopsy Is Feasible in Cervical Cancer Laparoscopic Surgery: A Single-Center Retrospective Cohort Study

Abstract

Background and Objective. Sentinel lymph node (SLN) biopsy efficiency has been confirmed in various solid tumors. This study aimed to assess SLN biopsy feasibility in clinical application and explore how to improve its detection rates and diagnostic accuracy in cervical cancer laparoscopic surgery. Methods. A total of 100 cervical cancer patients undergoing laparoscopic surgery with SLN biopsy were included. Indocyanine green, carbon nanoparticles (CNPs), and a combination of both were used during surgeries. Detection rates, sensitivity, negative predictive value (NPV) of SLN biopsy, and related factors were analyzed. Results. The overall and bilateral SLN detection rates were 92% (92/100) and 74% (74/100), respectively. Combined tracers had higher bilateral SLN detection rates than CNPs alone ( p = 0.005 ). Menopause and lymph node metastasis were associated with lower overall and bilateral SLN detection rates ( p < 0.05 ). SLN biopsy sensitivity and NPV for lymph node metastasis in patients with at least one detected SLN were 81.8% (9/11) and 97.3% (72/74), respectively. Among those with bilateral detected SLNs, higher sensitivity and NPV of 87.5% (7/8) and 98.3% (57/58) were observed, respectively. SLN algorithm can ensure that all patients with lymph node metastasis are detected by SLN biopsy. Conclusion. SLN biopsy appears to be safe and effective for specific cervical cancer patients with high detection rates and NPV in laparoscopic surgery, especially for those with detected bilateral SLNs and undergoing the SLN algorithm. Selecting suitable patients for SLN mapping has prospects for clinical application.

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

“…There are no adverse reactions reported yet, and the DR is quite high. Data from our hospital showed that the combination of CNP and ICG resulted a higher BDR of SLN in cervical and endometrial cancer comparing to CNP or ICG alone (p<0.05) (45,46).…”

Feasibility of Sentinel Lymph Node Mapping With Carbon Nanoparticles in Cervical Cancer: A Retrospective Study

“…[17][18][19] Recently, an increasing number of studies have focused on fluorescent indocyanine green (ICG) applied for SLN mapping of cervical cancer as it could improve SLN detection. 20,21 Hou et al 22 reported that the bilateral detection rate was significantly higher for combined ICG and CNP than CNP alone (75.3% vs 54.3%). However, ICG requires special fluorescence laparoscopy, whereas compared to traditional mapping techniques, CNS has more advantages, including no radiation exposure, no pain, no need for special instruments during operation, and a much lower cost.…”

The progress and prospect of sentinel lymph node mapping in endometrial carcinoma

“…Fluorescent dye indocyanine green (ICG), a safe and effective agent for SLNM, has emerged as the most recommended tracer for intraoperative detection of SLN in endometrial cancer owing to its higher sensitivity and specificity compared with conventional tracers (blue dye and radiotracer) [15,16,17] . In fact, Backes et al found that in contrast with ISB, ICG was conspicuously more effective in detecting SLN (ICG's detection rate is 83% while ISB's is 64%) [18] .…”