title: Sentinel lymph node biopsy in the management of gynecologic cancer.
abstract: OBJECTIVE
  To summarize current knowledge and recent advances in sentinel lymph node (SLN) concept in the three most frequent gynecological cancers.
  
  
  RESULTS
  In cervical cancer, SLN biopsy and ultrastaging has high sensitivity in lymph node staging in patients with bilaterally detected SLN. The presence of micrometastasis is associated with shortened survival. In endometrial cancer, SLN biopsy incorporating an institutional mapping algorithm and ultrastaging has been shown to significantly reduce false-negative rates and increase sensitivity and negative predictive value.
  
  
  CONCLUSIONS
  SLN biopsy and ultrastaging is useful in current management of patients with early-stage cervical cancer for multiple reasons, such as the reliable detection of key lymph nodes, identification of micrometastasis and intraoperative triage of patients. Although a complete or selective pelvic and paraaortic lymphadenectomy for adequate staging remains the standard treatment approach in patients with early-stage endometrial cancer, SLN biopsy has been shown to be safe and effective in detecting lymph node metastases. The application of the SLN procedure is safe in patients with early-stage unifocal squamous cell cancer of the vulva (<4  cm) and no suspicious enlarged lymph nodes at imaging.
authors.affiliation: aGynecologic Oncology Center, Department of Obstetrics and Gynecology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic bDepartment of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands cGynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: Cibula
authors.forename: Maaike H M
authors.initials: MH
authors.lastname: Oonk
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
mesh_terms: D000465:Algorithms; D004396:Coloring Agents; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007208:Indocyanine Green; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000473:pathology*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green