[Sentinel node identification in cervical cancer patients: a feasibility study].
OBJECTIVE
According to recommendations, the sentinel node (SN) procedure results causes of less radical treatment and reduction of morbidity.


METHODS
The aim of this study was to determine the feasibility of sentinel lymph node identification using radioisotopic lymphatic mapping with technetium-99m labelled nanocolloid and blue dye injection in patients with early-stage cervical cancer.


METHODS
100 patients with FIGO stage from IB1 to IIA primary carcinoma undergoing radical hysterectomy with pelvic lymphadenectomy have been investigated.


RESULTS
84% of the patients have been diagnosed with at least one-sided SN and 66% of them with two-sided SN. The sentinel detection rates, depending on the stages, were as following: 181-96.6%, IB12-66.7%, IIA-62.5%. Successful identification of SN was less likely in patients with tumors > 2cm (54% of SN) compared with those with tumors < or = 2cm (96% of SN). The false negative rate for the SN procedure was 3% (3/100). In all false negative SNs the primary cervical tumor was above 2cm and there was an isthmus infiltration. SN detection had 86.4% sensitivity, 100% specificity, and 95.3% negative predictive value.


CONCLUSIONS
Sentinel node mapping method for cervical cancer patients undergoing primary surgical therapy is a feasible option. The sentinel node detection rate is relatively high and depends on FIGO stage and the tumor size. The appliance of SN into cervical cancer procedures allows us to refrain from a surgery in favor of radiochemiotherapy, seems to be the right course of action in deciding treatment and may result in fewer postoperative complications rate.
Wydra
Dariusz
D
Katedra i Klinika Ginekologii i Ginekologii Onkologicznej AM w Gdańsku. dwydra@amg.gda.pl
Sawicki
Sambor
S
Emerich
Janusz
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013667:Technetium; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery
D019275:Radiopharmaceuticals; D013667:Technetium