Sentinel Lymph Node Mapping in Early-StageCervical Cancer

Overview

Objective:
The aim of this study was to determine the utilization and usefulness of intraoperativelymphatic mapping and sentinel node identifi cation with Patent blau in early stage cervicalcancer.Design: Prospective case observational study.Setting: Department of Obstetrics and Gynecology, Charles University, 2nd Medical Faculty, FacultyHospital Motol, Prague.Methods: From February 2000 to July 2002, 100 patients undergoing surgery for early cervicalcancer were included, 21 patients undergoing SNI (sentat laparoscopy and 79 patientsundergoing SNI at the time of radical abdominal hysterectomy after installation of blue dye(PatentBlau V 2.5%). We carefully inspected the lymphatic channels and sentinel nodes andperformed a preoperative frozen section of sentinel nodes. Finally, complete lymphadenectomywas done.Results: There was one false – negative result in the group of 100 women. In the group oftumors less than 20 mm the detection rate was 90.5% when laparoscopic detection was performedand 91.7% in laparotomic detection. In tumors more than 20 mm the detection rate was80% and in the group of 25 women with „bulky“ tumors IB2 after neoadjuvant chemotherapythe detection was 60% only. We analysed locoregional distribution of 176 sentinel lymph nodesin 75 women not undergoing neoadjuvant chemotherapy and distribution of 20 positivesentinel nodes.Conclusion: Detection of sentinel nodes in early stages of cervical carcinomas using patent blue dyeis a easy-to-perform, feasible and cheap method. Additional studies are necessary using radioisotopeto improve detection rate. Another prospective studies should evaluate the role of SNI in reductionin surgical radicality.

Key words:
sentinel node, cervical cancer, patent blau, radicality