Laparoscopic sentinel node biopsy in cervical cancer using a combined detection: 5-years experience.
BACKGROUND
To evaluate the feasibility after 5 years experience of a laparoscopic sentinel node (SN) procedure with combined radioisotopic and patent blue labeling in patients with cervical cancer.


METHODS
Sixty-seven patients (median age 48.9 years) with cervical cancer underwent a laparoscopic SN procedure using an endoscopic gamma probe, after both radioactive and patent blue injections. After the procedure, all the patients underwent complete laparoscopic pelvic/para-aortic lymphadenectomy.


RESULTS
At least one SN was identified in 57 patients (85.1%). According to the Stage, the SN identification rate was 91.2% in early-stage cervical cancer and 78.5% in locally advanced cervical cancer. The mean number of SN was 2.3 per patient (range 1-5). A total of 129 SNs were removed. Lymph node metastasis involvement was identified in the 20 SNs (15.5%) from 14 patients (24.6%). Nine of the 14 patients had at least one macrometastases, three patients presented micrometastases in H&S, and two patients presented isolated single cells. Six patients presented a pelvic non-SN involvement including two patients whose SNs were uninvolved. The false-negative SNs rate was 12.5% (two patients out of 16). Both patients have locally advanced cervical cancer.


CONCLUSIONS
This study confirms that laparoscopic SN detection with a combination of radiocolloid and patent blue is accurate in patients with early cervical cancer to assess pelvic lymph node status.
Coutant
Charles
C
Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020, Paris, France.
Morel
Olivier
O
Delpech
Yann
Y
Uzan
Serge
S
Daraï
Emile
E
Barranger
Emmanuel
E
D000328:Adult; D000368:Aged; D001706:Biopsy; D001918:Brachytherapy; D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D005188:False Negative Reactions; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008751:Methylene Blue; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013671:Technetium Tc 99m Sulfur Colloid; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*
D004396:Coloring Agents; C043260:May-Grunwald Giemsa; D019275:Radiopharmaceuticals; D012394:Rosaniline Dyes; D013671:Technetium Tc 99m Sulfur Colloid; C008769:sulfan blue; D008751:Methylene Blue; D004801:Eosine Yellowish-(YS)