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The sentinel node concept in early cervical cancer performs well in tumors smaller than 2 cm.

Darlin, Lotten LU ; Persson, Jan LU ; Bossmar, Thomas LU ; Lindahl, Bengt LU ; Kannisto, Päivi LU ; Måsbäck, Anna and Borgfeldt, Christer LU (2010) In Gynecologic Oncology 117(2). p.266-269
Abstract
OBJECTIVE: The aim of the study was to evaluate the sentinel node (SLN) concept for lymphatic mapping in early stage cervical cancer. METHODS: 105 women with early stage (1a1-2a) cervical cancer were scheduled for the sentinel node procedure in conjunction with a complete pelvic lymphadenectomy. The day before surgery, 1-1.5 mL 120MBq Tc(99) albumin nanocolloid was injected submucosally at four points around the tumor followed by a lymphoscintigram (LSG) to achieve an overview of the radiotracer uptake. RESULTS: During surgery, the overall detection rate (gamma probe) of at least one SLN was 90% (94/105 women) whereas at least one SLN was identified in 94% (61/65 women) with a tumor </=2 cm. Bilateral SLNs were identified in 62/105... (More)
OBJECTIVE: The aim of the study was to evaluate the sentinel node (SLN) concept for lymphatic mapping in early stage cervical cancer. METHODS: 105 women with early stage (1a1-2a) cervical cancer were scheduled for the sentinel node procedure in conjunction with a complete pelvic lymphadenectomy. The day before surgery, 1-1.5 mL 120MBq Tc(99) albumin nanocolloid was injected submucosally at four points around the tumor followed by a lymphoscintigram (LSG) to achieve an overview of the radiotracer uptake. RESULTS: During surgery, the overall detection rate (gamma probe) of at least one SLN was 90% (94/105 women) whereas at least one SLN was identified in 94% (61/65 women) with a tumor </=2 cm. Bilateral SLNs were identified in 62/105 (59%) of the women. Among 18 women with any metastatic lymph node 17 had a metastatic SLN (sensitivity 94%, 95% CI 73-100%). Among 61 women with a tumor </=2 cm, all five women with any metastatic lymph node also had a metastatic SLN (sensitivity 100%). One woman with a 1.5-cm squamous epithelial carcinoma had metastatic positive SLNs on each side but also one metastatic bulky (>2 cm) node without radiotracer uptake. The negative predictive value for patients with cervical cancers </=2 cm was 100%. CONCLUSIONS: The SLN-technique seems to be an accurate method for identifying lymph node metastases in cervical cancer patients with tumors of 2 cm or smaller. In case of a unilateral SLN only, a complete lymphadenectomy should be performed on the radionegative side. All bulky nodes must be removed. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gynecologic Oncology
volume
117
issue
2
pages
266 - 269
publisher
Academic Press
external identifiers
  • wos:000277538600019
  • pmid:20167355
  • scopus:77950187542
ISSN
1095-6859
DOI
10.1016/j.ygyno.2010.01.035
language
English
LU publication?
yes
id
86b30d86-aab9-4568-b531-598c051d85a1 (old id 1552528)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20167355?dopt=Abstract
date added to LUP
2010-03-03 13:38:07
date last changed
2018-05-29 11:39:33
@article{86b30d86-aab9-4568-b531-598c051d85a1,
  abstract     = {OBJECTIVE: The aim of the study was to evaluate the sentinel node (SLN) concept for lymphatic mapping in early stage cervical cancer. METHODS: 105 women with early stage (1a1-2a) cervical cancer were scheduled for the sentinel node procedure in conjunction with a complete pelvic lymphadenectomy. The day before surgery, 1-1.5 mL 120MBq Tc(99) albumin nanocolloid was injected submucosally at four points around the tumor followed by a lymphoscintigram (LSG) to achieve an overview of the radiotracer uptake. RESULTS: During surgery, the overall detection rate (gamma probe) of at least one SLN was 90% (94/105 women) whereas at least one SLN was identified in 94% (61/65 women) with a tumor &lt;/=2 cm. Bilateral SLNs were identified in 62/105 (59%) of the women. Among 18 women with any metastatic lymph node 17 had a metastatic SLN (sensitivity 94%, 95% CI 73-100%). Among 61 women with a tumor &lt;/=2 cm, all five women with any metastatic lymph node also had a metastatic SLN (sensitivity 100%). One woman with a 1.5-cm squamous epithelial carcinoma had metastatic positive SLNs on each side but also one metastatic bulky (&gt;2 cm) node without radiotracer uptake. The negative predictive value for patients with cervical cancers &lt;/=2 cm was 100%. CONCLUSIONS: The SLN-technique seems to be an accurate method for identifying lymph node metastases in cervical cancer patients with tumors of 2 cm or smaller. In case of a unilateral SLN only, a complete lymphadenectomy should be performed on the radionegative side. All bulky nodes must be removed.},
  author       = {Darlin, Lotten and Persson, Jan and Bossmar, Thomas and Lindahl, Bengt and Kannisto, Päivi and Måsbäck, Anna and Borgfeldt, Christer},
  issn         = {1095-6859},
  language     = {eng},
  number       = {2},
  pages        = {266--269},
  publisher    = {Academic Press},
  series       = {Gynecologic Oncology},
  title        = {The sentinel node concept in early cervical cancer performs well in tumors smaller than 2 cm.},
  url          = {http://dx.doi.org/10.1016/j.ygyno.2010.01.035},
  volume       = {117},
  year         = {2010},
}