title: Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer.
abstract: BACKGROUND
  The purpose of this study was to assess the feasibility and accuracy of sentinel lymph nodes (SLNs) detection using 99mTc phytate in predicting pelvic lymph nodes status for radical abdominal trachelectomy (RAT) in patients with early stage cervical cancer.
  
  
  METHODS
  Sixty-eight women with stage IA2-IB1 cervical cancer and scheduled to undergo fertility-sparing surgery enrolled in this study. 99mTc-labeled phytate was injected before surgery. Intraoperatively, SLNs were identified, excised, and submitted to fast frozen section. Systematic bilateral pelvic lymphadenectomy and/or para-aortic lymph node dissection was performed. Then RAT was performed in patients with negative SLNs. All nodes were sent for routine pathological examination and immunostained with anti-cytokeratin antibody to detect micrometastases. Outcomes of follow up and fertility were observed.
  
  
  RESULTS
  SLNs were identified in 64 of 68 patients (94.1%). Of these, SLNs of 8 patients (11.8%) were positive on frozen sections and proved to be metastasis by final pathologic examination. The sensitivity, accuracy, and false negative rates were 100%, 100%, and 0%, respectively. All 60 patients with negative SLN underwent RAT successfully. Two relapses occurred and no one died of tumor progression during follow-up. Five of the 15 patients with procreative desire conceived 8 pregnancies (3 term delivery, 2 premature birth, 1 spontaneous abortion, and 2 were still in the duration of pregnancy) after surgery.
  
  
  CONCLUSIONS
  The identification of SLN using 99mTc-labeled phytate is accurate and safe to assess pelvic nodes status in patients with early cervical cancer. SLNs biopsy guided RAT is feasible for patients who desire to have fertility preservation.
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117, P.R. China.
authors.forename: Xue-Lian
authors.initials: XL
authors.lastname: Du
authors.forename: Xiu-Gui
authors.initials: XG
authors.lastname: Sheng
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
authors.forename: Qing-Shui
authors.initials: QS
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Yu
authors.forename: Chun-Xia
authors.initials: CX
authors.lastname: Pan
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Lu
authors.forename: Cong
authors.initials: C
authors.lastname: Wang
authors.forename: Qu-Qing
authors.initials: QQ
authors.lastname: Song
mesh_terms: D000328:Adult; D017024:Chemotherapy, Adjuvant; D005260:Female; D005629:Frozen Sections / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D015609:Organotechnetium Compounds; D010388:Pelvis / Q000473:pathology / Q000601:surgery; D010833:Phytic Acid; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C026177:technetium phytate; D010833:Phytic Acid