Abstract
Lymph node status is the most important independent prognostic factor in early stage cervical cancer. Intraoperative lymphatic mapping and sentinel lymph node detection have been increasingly evaluated in the treatment of a variety of solid tumors, particularly breast cancer and cutaneous melanoma. This study evaluated the feasibility of these procedures in patients undergoing radical hysterectomy with pelvic lymphadenectomy for early cervical cancer. A total of 30 patients with histologically diagnosed FIGO stage IA to IIA cervical cancer were enrolled to this study. They were scheduled to undergo radical abdominal hysterectomy and pelvic lymphadenectomy after injecting patent blue dye in cervix. A total of 60 SLNs (mean 2.5) were detected in 24 patients with detection rate of 80%. Bilateral SLNs were detected in 70.1% of cases. SLNs were identified in obturator and external iliac areas in 50% and 31.7%, respectively; no SLNs were discovered in the common iliac region. Seven patients (23.3%) had lymph node metastases; one of these had false negative SLN.The false negative rate and negative predictive value were 14.3% and 94.4%, respectively. SLN detection procedure with blue dye technique is a feasible procedure in cervical cancer. Patent blue dye is cheap, safe and effective tracer to detect sentinel node in carcinoma of cervix.
Highlights
Lymph node status is the most important independent prognostic factor in early stage cervical cancer
Intraoperative lymphatic mapping and sentinel lymph node detection have been increasingly evaluated in the treatment of a variety of solid tumors, breast cancer and cutaneous melanoma
This study evaluated the feasibility of these procedures in patients undergoing radical hysterectomy with pelvic lymphadenectomy for early cervical cancer
Summary
Lymph node status is the most important independent prognostic factor in early stage cervical cancer. This study evaluated the feasibility of these procedures in patients undergoing radical hysterectomy with pelvic lymphadenectomy for early cervical cancer. The sentinel lymph node (SLN) is the first node to receive lymphatic drainage from primary tumor, so that when nodal metastases occur, it will be first to be involved. Cervical cancer is a good candidate disease for lymphatic mapping because of the following important reasons: firstly, because the incidence of nodal metastases is 016% in patients with cervical tumor size less than or equal to 2 cm and 15-31% in patients with overall stage IB; many patients with negative nodes will derive. Acharya et al Sentinel Lymph Node Detection in Patients with Early Cervical Cancer no benefit, but will develop short and long-term morbidity related to lymphadenectomy. The methods used in different studies were blue dye, radio colloid tracer and or a combination of both with using gamma probe detector.
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