title: The sentinel node concept in early cervical cancer performs well in tumors smaller than 2 cm.
abstract: OBJECTIVE
  The aim of the study was to evaluate the sentinel node (SLN) concept for lymphatic mapping in early stage cervical cancer.
  
  
  METHODS
  105 women with early stage (1a1-2a) cervical cancer were scheduled for the sentinel node procedure in conjunction with a complete pelvic lymphadenectomy. The day before surgery, 1-1.5 mL 120MBq Tc(99) albumin nanocolloid was injected submucosally at four points around the tumor followed by a lymphoscintigram (LSG) to achieve an overview of the radiotracer uptake.
  
  
  RESULTS
  During surgery, the overall detection rate (gamma probe) of at least one SLN was 90% (94/105 women) whereas at least one SLN was identified in 94% (61/65 women) with a tumor <or=2 cm. Bilateral SLNs were identified in 62/105 (59%) of the women. Among 18 women with any metastatic lymph node 17 had a metastatic SLN (sensitivity 94%, 95% CI 73-100%). Among 61 women with a tumor <or=2 cm, all five women with any metastatic lymph node also had a metastatic SLN (sensitivity 100%). One woman with a 1.5-cm squamous epithelial carcinoma had metastatic positive SLNs on each side but also one metastatic bulky (>2 cm) node without radiotracer uptake. The negative predictive value for patients with cervical cancers <or=2 cm was 100%.
  
  
  CONCLUSIONS
  The SLN-technique seems to be an accurate method for identifying lymph node metastases in cervical cancer patients with tumors of 2 cm or smaller. In case of a unilateral SLN only, a complete lymphadenectomy should be performed on the radionegative side. All bulky nodes must be removed.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Lund, SE-221 85 Lund, Sweden.
authors.forename: Lotten
authors.initials: L
authors.lastname: Darlin
authors.forename: Jan
authors.initials: J
authors.lastname: Persson
authors.forename: Thomas
authors.initials: T
authors.lastname: Bossmar
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindahl
authors.forename: Päivi
authors.initials: P
authors.lastname: Kannisto
authors.forename: Anna
authors.initials: A
authors.lastname: Måsbäck
authors.forename: Christer
authors.initials: C
authors.lastname: Borgfeldt
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid