Sentinel node detection with 99mTc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy

Lymph node status is the most important prognosticator of survival among women with early stage cervical cancer. This means that many cervical cancer patients will undergo pelvic lymphadenectomy as part of their treatment. Unfortunately, this procedure is associated with significant morbidity. Utilizing the sentinel lymph node technique for women with cervical cancer has the potential to decrease this morbidity. Multiple studies have suggested that sentinel lymph node mapping in these patients is feasible with excellent detection rates and sensitivity. This review examines the current body of literature regarding sentinel lymph node biopsy among women with cervical cancer.

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“…[17] Other studies have subsequently demonstrated a sensitivity ranging from 94% – 100%. [11, 15, 16, 19, 26]…”

Section: Sentinel Node Studiesmentioning

confidence: 99%

Sentinel Lymph Node Evaluation in Women with Cervical Cancer

Holman

Levenback

Frumovitz

2014

Journal of Minimally Invasive Gynecology

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“…For the remaining studies, the full text was read. Finally, a total of 17 studies were included in the analysis, involving a total of 1,112 patients (5,6,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). The study selection process is summarized in Fig.…”

Section: Study Selection and Descriptionmentioning

confidence: 99%

Sentinel lymph node biopsy in cervical cancer: A meta-analysis

et al. 2013

Molecular and Clinical Oncology

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Abstract. Sentinel lymph node biopsy (SLNB) is used to determine the pathological status of the first lymph node receiving lymphatic drainage from the primary tumor. The diagnostic value of SLNB for the assessment of the nodal status in patients with cervical cancer has not been determined. Therefore, this meta-analysis was conducted to assess the diagnostic value of SLNB in cervical cancer. A search for related literature was performed using PubMed. Data were analyzed using a random effects model and a subgroup analysis was used to assess the diagnostic value of different practices during the process. A total of 17 studies involving a total of 1,112 patients were included in the analysis. The pooled sentinel lymph node (SLN) detection rate, sensitivity and negative predictive values were 92.2% [95% confidence interval (CI): 88.3-94.8%], 88.8% (95% CI: 85.1-91.7%) and 95.0% (95% CI: 92.8-96.6%), respectively. The subgroup analysis revealed that laparoscopy, tracer combination and immunohistochemistry were associated with a higher SLN detection rate. In conclusion, the SLNB in cervical cancer appears to be of diagnostic value, particularly the procedure with the combination of laparoscopy, combined tracers and immunohistochemistry. However, further studies are required to establish the clinical value of SLNB in cervical cancer.

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“…On the day before surgery, 99m Tc-labeled phytate (148 MBq [4.0 mCi] per patient) was injected subepithelially into 4 quadrants (3, 6, 9, and 12 o'clock positions) of the cervix [10]. After injection, lymphoscintigraphy was performed.…”

Section: Sln Identificationmentioning

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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Sentinel node detection with 99mTc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy

Abstract: We conclude SLN detection using (99m)Tc-labeled phytate is satisfactory to assess pelvic nodes in patients with early cervical cancer; if validated with other research, it should be incorporated into clinical practice.

Cited by 48 publications

References 26 publications

Sentinel Lymph Node Evaluation in Women with Cervical Cancer

Sentinel Lymph Node Evaluation in Women with Cervical Cancer

Sentinel lymph node biopsy in cervical cancer: A meta-analysis

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

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