The role of sentinel lymph node biopsy in cervical cancer: an overview of the literature

Abstract

Cervical cancer is the second most common cancer in southern African women. Although the FIGO staging does not include lymph node status, lymph node metastasis is an important risk factor for recurrence and death in patients with early cervical cancer. Accurate information about lymph node metastasis is crucial to decide on optimal individualised treatment. Complete pelvic lymphadenectomy is the current standard used to obtain accurate information on lymph node status. Because of the low incidence of nodal metastasis in patients with early cervical cancer, identifying women in whom lymphadenectomy can be safely avoided would result in less morbidity associated with pelvic lymphadenectomy, without compromising overall and disease-free survival. Over the past 15 years, the role of sentinel lymph node (SLN) biopsy has been studied extensively in patients with early-stage cervical cancer. Assessment of the SLN in women with early-stage disease may potentially offer an alternative to complete lymphadenectomy. Data are limited with regard to the role of SLN assessment in patients with cervical cancer in low-resource settings where the prevalence of HIV and other gynaecological infections is high.