Role of sentinel lymph node biopsy procedure in cervical cancer: a critical point of view.
OBJECTIVE
To report our experience about the role of sentinel node biopsy in cervical cancer patients while debating provocatory arguments concerning this procedure.


METHODS
From June 2001 to February 2003, patients affected by stage IB(1) cervical cancer were submitted to the sentinel node biopsy procedure. Patients were submitted to lymphoscintigraphy and, subsequently, to laparoscopy in order to locate the sentinel lymph node.


RESULTS
Thirty-seven patients were enrolled in the study. Sentinel node(s) was(were) identified with preoperative lymphoscintigraphy in 89% of the patients. Intraoperative detection rate was 70%. During surgery in 31% of the patients, sentinel node was detected bilaterally; in 15%, two sentinel nodes on the same side of the lymphatic vessels were detected. The sentinel node was located at the level of superficial common iliac vessels (26%), external iliac vessels (69%), and superficial obturator vessels (49%). In 77% of the patients, the histologic specimen sent by the surgeon as unique sentinel node contained two or more nodes. Metastatic sentinel nodes were found in 23% of the patients. There was no case with a positive nonsentinel node in the presence of a negative sentinel node.


CONCLUSIONS
Sentinel node detection is a feasible procedure in cervical cancer patients. However, a high percentage of patients is found with bilateral and/or more than one sentinel lymph node. Improvements in detection rate and pathological analysis are needed prior to consider the sentinel node biopsy a routine procedure in cervical cancer patients.
Angioli
Roberto
R
Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, Via Longoni, 83-00155 Rome, Italy.
Palaia
Innocenza
I
Cipriani
Cesidio
C
Muzii
Ludovico
L
Calcagno
Marco
M
Gullotta
Gabriella
G
Panici
Pierluigi Benedetti
PB
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin