title: Accuracy of Sentinel Lymph Node Mapping After Previous Hysterectomy in Patients with Occult Cervical Cancer.
abstract: In patients with a diagnosis of occult cervical cancer made on a hysterectomy specimen after surgery for a benign indication, lymph node assessment is crucial to determine treatment. We aimed to compare sentinel lymph node (SLN) mapping between patients with postoperative diagnosis of occult cervical carcinoma and patients with cervical cancer and uterus in situ.
  
  
  
  A retrospective analysis of cervical cancer patients International Federation of Gynecology and Obstetrics (FIGO) stage IA-IIA disease undergoing laparoscopic SLN mapping was performed. Patients were divided into two groups: those with a diagnosis of occult cervical cancer made on a hysterectomy specimen (group 1) and those with a diagnosis of cervical cancer and uterus in situ (group 2). Tracers used for SLN mapping included technetium-99m ((99m)Tc), blue dye, and indocyanine green. After detection and excision, the SLN was sent for frozen section analysis, and the planned surgical procedure was aborted in case of metastatic disease in favor of a chemoradiotherapeutic treatment.
  
  
  
  Groups 1 and 2 included 9 and 62 patients, respectively. Clinicopathologic characteristics were similar among the two groups. Overall and bilateral detection rates were 66.6 and 33.3 and 95.1 and 87 % in groups 1 and 2, respectively (p < 0.05). No false-negative SLNs were identified in either group, with a negative predictive value of 100 %.
  
  
  
  SLN mapping in occult cervical cancer patients has lower detection rates compared to patients with uterus in situ. In these patients, proper management of their disease has already failed before diagnosis, and additional mistakes may definitely compromise attempts at cure.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland. andrea.papadia@insel.ch.
authors.forename: Andrea
authors.initials: A
authors.lastname: Papadia
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Imboden
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Anja
authors.initials: A
authors.lastname: Fink
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.|Department of Gynecology and Obstetrics, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Gasparri
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Daniele
authors.initials: D
authors.lastname: Bolla
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007208:Indocyanine Green; D061305:Lymphoscintigraphy; D008875:Middle Aged; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy; D013668:Technetium Tc 99m Aggregated Albumin; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D007208:Indocyanine Green