title: Sentinel lymph node biopsy improves staging in early cervical cancer.
abstract: OBJECTIVE
  The main study objective was to describe the distribution of sentinel lymph nodes (SLNs) and the prevalence of SLN micrometastases in patients with early cervical cancer. The secondary objective was to confirm the SLN detection rate and negative predictive value found in our preliminary study.
  
  
  METHODS
  We prospectively included 25 patients with early cervical cancer, each of whom received an injection of 120 MBq of technetium-99m for preoperative lymphoscintigraphy and intraoperative node detection using an endoscopic gamma probe. Patent blue dye was injected intraoperatively. SLNs were sought in the pelvic and para-aortic drainage areas. Radical iliac dissection was performed routinely at the end of the procedure. SLNs were examined after hematoxylin-eosin-saffron staining; negative specimens were assessed using immunohistochemistry.
  
  
  RESULTS
  Most (85%) of the SLNs were in the inter-iliac territory. Para-aortic or parametrial SLNs were found respectively in 2 patients and common iliac SLNs in 5 patients. Thus 9/25 patients had additional information due to SLN detection. One metastasis and one micrometastasis were detected in SLNs. No patients had positive non-sentinel nodes with negative SLNs.
  
  
  CONCLUSIONS
  SLN detection ensures the identification of SLNs in unusual locations in 36% of patients. SLN disease was found in 8% of our patients. Thus, SLN biopsy improves staging in patients with early cervical cancer. Studies in larger patient populations are needed to evaluate the clinical impact of SLN biopsy.
authors.affiliation: Service de Chirurgie Gynécologique, Hôpital Européen Georges Pompidou, 20 rue Leblanc 75015 Paris, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Bats
authors.forename: Denys
authors.initials: D
authors.lastname: Clément
authors.forename: Florence
authors.initials: F
authors.lastname: Larousserie
authors.forename: Marie-Aude
authors.initials: MA
authors.lastname: Lefrère-Belda
authors.forename: Marc
authors.initials: M
authors.lastname: Faraggi
authors.forename: Marc
authors.initials: M
authors.lastname: Froissart
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lécuru
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012211:Rhenium; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D017556:Technetium Compounds; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D019275:Radiopharmaceuticals; D017556:Technetium Compounds; C030576:technetium Tc 99m rhenium colloid; D012211:Rhenium