Laparoscopic assessment of the sentinel lymph nodes in early cervical cancer. Technique--preliminary results and future developments.
Laparoscopic assessment of the sentinel node (SN) in early stage cervical cancer is both feasible and safe. The technique is described. The data concerning the 70 first assessed patients are reported. Failure in identification of the SN occurred in 14 of the 139 attempted dissections. One only SN was detected in 121 dissections and two SN in four dissections. A systematic pelvic lymphadenectomy was carried out after removal of the SN. A metastatic involvement of the SN was put in evidence in 19 of the 129 retrieved SN. The other regional lymph nodes were. The data concerning the 70 first assessed patients are reported. Failure in identification of the SN occurred in 14 of the 139 attempted dissections. One only SN was detected in 121 dissections and two SN in four dissections. A systematic pelvic lymphadenectomy was carried out after removal of the SN. A metastatic involvement of the SN was put in evidence in 19 of the 129 retrieved SN. The other regional lymph nodes were involved in 13 cases and not involved in six cases. In the 110 cases where the SN was not involved all the other regional nodes were free from metastasis. At the condition larger series confirm the preliminary results the laparoscopic retrieval of the SN could change the strategy to be used in the management of early stage cervical cancer: no systematic lymphadenectomy-radiotherapy for the SN+ patients--vaginal radical hysterectomy for the SN- patients. Another condition should be the SN is submitted to superstaging using immunochemical staining and/or molecular biology.
Dargent
Daniel
D
Service de Gynécologie Pavillon L, Hôpital Edouard Herriot, 5, Place d'Arsonval, 69437 Lyon, France. daniel.dargent@chu-lyon.fr
Enria
Raffaella
R
D000465:Algorithms; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D009362:Neoplasm Metastasis / Q000175:diagnosis; D021701:Sentinel Lymph Node Biopsy; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy