title: Abdominal radical trachelectomy guided by sentinel lymph node biopsy for stage IB1 cervical cancer with tumors >2 cm.
abstract: Accuracy of prediction of pelvic lymph node status using sentinel lymph node biopsy (SLNB), and outcomes of SLNB-guided abdominal radical trachelectomy (ART) were assessed. Patients with stage IB1 (Figure 2009) cervical cancer and with tumors >2 cm were enrolled. Prior to fertility-sparing surgery 99mTc-labeled phytate was administered. SLNs were intraoperatively identified, excised, and assessed using fast-frozen sections. Systematic bilateral pelvic lymphadenectomy with or without para-aortic lymphadenectomy was subsequently undertaken. The SLN detection rate was 91.8% (45/49 patients); 8.2% (4/49) had radical hysterectomies because of metastatic primary SLNs. All SLNs received routine immunopathological examination to detect micrometastasis. Sensitivity, accuracy, and false negative rates were 100%, 100%, and 0%, respectively. ART was successfully completed in 45 patients (median follow-up, 61 [range, 4-149] months). Three of the 45 (6.7%) were lost to follow-up; two relapsed and one died of tumor progression. Overall 3-year survival and progression-free survival rates were 97.6% and 95.2%, respectively. Of the 19 patients who attempted to conceive after surgery, five achieved pregnancy, and one had a live birth in the third trimester. We concluded that SLNB using 99mTc-labeled phytate can accurately assess pelvic node status. SLNB-guided ART is safe and feasible in patients selected for fertility-sparing procedures.
authors.affiliation: School of Medicine and Life Sciences, University of Jinan, Jinan 250022, Shandong, People's Republic of China.|Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Xiangyun
authors.initials: X
authors.lastname: Deng
authors.affiliation: School of Medicine and Life Sciences, University of Jinan, Jinan 250022, Shandong, People's Republic of China.|Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Li
authors.affiliation: Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Zhang
authors.affiliation: School of Medicine and Life Sciences, University of Jinan, Jinan 250022, Shandong, People's Republic of China.|Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.affiliation: School of Medicine and Life Sciences, University of Jinan, Jinan 250022, Shandong, People's Republic of China.|Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People's Republic of China.|Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People's Republic of China.
authors.forename: Xiugui
authors.initials: X
authors.lastname: Sheng
mesh_terms: D000328:Adult; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011183:Postoperative Complications; D012008:Recurrence; D021701:Sentinel Lymph Node Biopsy; D000069339:Trachelectomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult
keywords: abdominal radical trachelectomy; cervical cancer; oncological outcomes; sentinel lymph node; tumor >2 cm