Sentinel Lymph Node Identification in Patients with Stage IB1 Invasive Cervical Carcinoma

Abstract

Background and Objectives: To establish the feasibility of sentinel lymph node (SLN) identification in patients with stage IB1 invasive cervical cancer. Methods: Selected patients with cervical cancer scheduled for radical hysterectomy with bilateral pelvic lymphadenectomy underwent SLN detection. Preoperatively, 1 mCi of technetium-99 (99Tc) was injected into four points of the superficial cervical stroma around the tumor. Intraoperatively, the patients underwent gamma-probe-guided lymphatic mapping, and patent blue dye was injected into the same points as the 99Tc. Results: Of the 12 eligible patients, 11 (92%) had at least one SLN detected. Seven (64%) patients had SLNs detected by intraoperative lymphoscintigraphy and the blue-dye technique, 3 (27%) by intraoperative lymphoscintigraphy, and 1 (9%) by the blue-dye technique only. Intraoperatively, 22 SLNs were detected: 9 (41%) by lymphoscintigraphy, 7 (32%) by lymphoscintigraphy and the blue-dye technique, and 6 (27%) by the blue-dye technique only. Six patients (54.5%) had bilateral SLNs. Sensitivity, specificity, positive predictive value, and negative predictive value for SLN detection were 100%, 80%, 33%, and 100%, respectively. There were no false-negative results. Conclusions: In this small cohort of patients, the combination of 99Tc and patent blue dye was safe and feasible for the detection of SLNs in early-stage cervical cancer. This study investigates the sentinel lymph node technique in patients with stage IB1 cervical cancer.