Sentinel lymph node biopsy in gynaecological cancers: the importance of micrometastases in cervical cancer.
Lymph node metastases is a recognized prognostic factor in women with cervical cancer. However, there is a need for consensual histological definition of micrometastases in this indication which could give rise to a classification system similar to that used in breast cancer. We thus conducted a MEDLINE and EMBASE database analysis to evaluate the concept of micrometastases in cervical cancer. Retrospective studies place the incidence of micrometastasis between 1.5 and 15% depending on the technique used to evaluate lymph node status. Sentinel lymph node biopsy with serial sectioning and immunohistochemical analysis appears to be the most accurate micrometastases detection technique. The value of RT-PCR in micrometastases detection remains to be clarified by further studies. From a clinical view point, few data are available to support the prognostic relevance of micrometastases. However, case control and longitudinal studies have underlined the risk of recurrence in women with micrometastases, raising the issue of a revision of adjuvant therapy indications in this specific population.
Daraï
Emile
E
Department of Gynaecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, CancerEst, Université Pierre et Marie Curie, Paris 6, France. emile.darai@tnn.aphp.fr
Rouzier
Roman
R
Ballester
Marcos
M
Barranger
Emmanuel
E
Coutant
Charles
C
D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000556:secondary; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000556:secondary*