Lymph node mapping and sentinel node detection in patients with cervical carcinoma: a 2-year experience.
OBJECTIVE
To describe our experience with the sentinel lymph node biopsy in cervical cancer patients, using a laparotomic approach and blue dye technique.


METHODS
Between January 2003 and January 2005, patients with histologically proven FIGO stage IA2 to IIA carcinoma of the uterine cervix were submitted to SLN procedure if they were scheduled to have radical abdominal hysterectomy and pelvic lymphadenectomy. The SLN mapping was done after intracervical methylene blue (4 ml) injection. Final pathologic evaluation of SLNs included serial step sections and wide spectrum cytokeratin immunohistochemical analysis.


RESULTS
Fifty patients were accrued to this prospective observational double-center study. A total of 86 SLNs (mean 1.9) were identified in the 45 patients with fruitful quest for SLN detection. The SLN detection rate per patient was 90%, and for the side of dissection, 72%. Bilateral SLNs were detected in 60% of cases. SLNs were identified in the external iliac and obturator areas in 55% and 38%, respectively; 5 isolated SLNs were discovered in the common iliac region. Ten patients (20%) had lymph node metastases; one of these had false-negative SLN. The false-negative rate and the negative predictive value, calculated by patient and by side of dissection, were 10% and 97.2%, and 8.3% and 98.4%, respectively.


CONCLUSIONS
SLN detection with blue dye is a feasible procedure, particularly useful as a surgical staging procedure in young patients with small tumors. The true morbidity-sparing role of this technique in cervical cancer treatment is yet to be found.
Di Stefano
Andrea B
AB
Department of Obstetrics and Gynecology I. Panella, University of Catania, Italy. andreazippo@hotmail.com
Acquaviva
Giusi
G
Garozzo
Gaetano
G
Barbic
Matija
M
Cvjeticanin
Branko
B
Meglic
Leon
L
Kobal
Borut
B
Rakar
Stelio
S
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008751:Methylene Blue; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery
D008751:Methylene Blue