Sentinel node (SLN) biopsy in the management of locally advanced cervical cancer
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
19646741
DOI
10.1016/j.ygyno.2009.06.017
PII: S0090-8258(09)00470-3
Knihovny.cz E-resources
- MeSH
- Coloring Agents MeSH
- Sentinel Lymph Node Biopsy methods standards MeSH
- Adult MeSH
- False Positive Reactions MeSH
- Laparoscopy MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymph Node Excision MeSH
- Lymph Nodes pathology surgery MeSH
- Young Adult MeSH
- Uterine Cervical Neoplasms pathology surgery MeSH
- Rosaniline Dyes MeSH
- Aged MeSH
- Neoplasm Staging MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Coloring Agents MeSH
- Rosaniline Dyes MeSH
- sulfan blue MeSH Browser
OBJECTIVES: Sentinel lymph node (SLN) biopsy can significantly contribute to the management of locally advanced cervical cancers with high risk of lymph node (LN) positivity. However, low detection rate and sensitivity were reported in larger tumors, albeit on a small number of cases. It was the aim of our study to verify the SLN reliability in large tumors, with modified dye application technique and a careful identification of side-specific lymphatic drainage. METHODS: The study involved 44 patients with tumors 3 cm in diameter or larger, stages IB1 to IIA, or selected IIB. In cases where SLN could not be detected, systematic pelvic lymphadenectomy was performed on the respective side. Systematic pelvic lymphadenectomy was performed during the second step radical procedure if not already done. RESULTS: Detection rate in the whole cohort reached 77% per patient and 59% bilaterally. No significant difference was found whether a blue dye or a combined method was used (75% vs 80%, and 55% vs 67%). Systematic pelvic lymphadenectomy was performed in cases with undetected SLN unilaterally in 8 and bilaterally in 10 women. A systematic pelvic lymphadenectomy was included in the second step radical procedure in 19 cases and no positive LN were found. There was no case of false-negative SLN result in patients who underwent surgical treatment. CONCLUSION: Detection rate in locally advanced cervical cancer could be improved by a careful dye application technique. Low false-negative SLN rate could be achieved if pelvic lymphatic drainage is evaluated on a side-specific principle by performing systematic lymphadenectomy if SLN is not detected.
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