title: Contribution of pelvic and para-aortic lymphadenectomy with sentinel node biopsy in patients with IB2-IIB cervical cancer.
abstract: OBJECTIVE
  Detection of lymph node involvement in women with IB2-IIB cervical cancer could have a positive effect on survival. We set out to evaluate the incidence of pelvic and/or para-aortic lymph node involvement using the sentinel node (SN) biopsy and its impact on survival.
  
  
  METHODS
  From 2002 to 2010, 66 women with IB2-IIB cervical cancer underwent a pelvic and paraaortic lymphadenectomy with SN biopsy. Survival between groups according to lymph node status was evaluated.
  
  
  RESULTS
  Mean tumour size was 43.5 mm. At least one SN was detected in 69% of the 45 SN procedures performed. Sixteen of these patients had metastatic SN and the false negative rate was 20%. Metastatic pelvic SNs or non-SNs were detected in 33 patients (50%), including pelvic-positive nodes in 26 (40%), pelvic- and paraaortic-positive lymph nodes in seven (11%), and paraaortic skip metastases in two (6%). Positive paraaortic node was the sole determinant for disease-free survival (DFS) and overall survival (OS; P<0.001). Differences in DFS and OS between groups according to the nodal status were observed (P<0.001).
  
  
  CONCLUSIONS
  SN procedure gave a higher rate of metastasis detection. Further studies are required to evaluate whether pre-therapeutic node staging, including paraaortic and pelvic lymphanedectomy, should be performed.
authors.affiliation: Department of Gynecology-Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, CancerEst, Université Pierre et Marie Curie Paris 6, 4 rue de la Chine, Paris 75020, France. elisabeth.chereau@gmail.com
authors.forename: E
authors.initials: E
authors.lastname: Chéreau
authors.forename: J-G
authors.initials: JG
authors.lastname: Feron
authors.forename: M
authors.initials: M
authors.lastname: Ballester
authors.forename: C
authors.initials: C
authors.lastname: Coutant
authors.forename: C
authors.initials: C
authors.lastname: Bezu
authors.forename: R
authors.initials: R
authors.lastname: Rouzier
authors.forename: E
authors.initials: E
authors.lastname: Touboul
authors.forename: E
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001011:Aorta / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology / Q000601:surgery; D011878:Radiotherapy; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents