Clinical value of preoperative lymphoscintigraphy in patients with early cervical cancer considered for intraoperative lymphatic mapping.
The purpose of this study was to examine the clinical usefulness of preoperative lymphoscintigraphy (PLS) for sentinel node identification in patients undergoing lymphatic mapping during surgery for early cervical cancer.


METHODS
Day-before PLS was performed in 42 patients who were candidates for open radical hysterectomy and intraoperative lymphatic mapping, using a combination of radiocolloid and blue dye technique.


RESULTS
In 39 patients, at least one sentinel node (SN) was evident either in the lymphoscintigram or during the operation (detection rate 92.8%). Lymphoscintigraphy revealed unilateral SNs in 24 (61.5%) cases and bilateral SNs in 15 (38.5%). A total of 56 SNs were identified. Intraoperatively, 5 out of 24 patients with unilateral SNs on PLS had bilateral identification. The total number of SNs retrieved was 103 (2.6/patient). While one SN was identified in 25 cases on PLS, 32 patients had two or more SNs intraoperatively. The agreement between preoperative and intraoperative detection regarding laterality, number and location of SNs was poor (Kappa<0.69).


CONCLUSIONS
PLS is of limited clinical value for intraoperative SN detection in early cervical cancer.
Second Department of Obstetrics and Gynecology, University of Athens, School of Medicine, Aretaieion Hospital, Vas. Sofias Ave. 76, Athens 11528, Greece. foste@otenet.gr
Stelios
S
Fotiou
Petros
P
Zarganis
George
G
Vorgias
Erasmia
E
Trivizaki
Konstantinos
K
Velentzas
Thrassyvoulos
T
Akrivos
George
G
Creatsas
D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011877:Radionuclide Imaging / Q000379:methods; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*
D013668:Technetium Tc 99m Aggregated Albumin