Sentinel Lymph Node Mapping in Early-Stage
Cervical Cancer
Rob L.1, Charvát M.1, Robová H.1, Strnad P.1, Pluta M.1, Schlegerová D.2
1Gynekologicko-porodnická klinika, 2. LF UK, FN Motol, Praha, přednosta doc. MUDr. L. Rob, CSc. 2Ústav patologie a molekulární medicíny, 2. LF UK, FN Motol, Praha, přednosta prof. MUDr. R. Kodet, CSc. |
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Summary:
Objective: The aim of this study was to determine the utilization and usefulness of intraoperative
lymphatic mapping and sentinel node identifi cation with Patent blau in early stage cervical
cancer.
Design: Prospective case observational study.
Setting: Department of Obstetrics and Gynecology, Charles University, 2nd Medical Faculty, Faculty
Hospital Motol, Prague.
Methods: From February 2000 to July 2002, 100 patients undergoing surgery for early cervical
cancer were included, 21 patients undergoing SNI (sentat laparoscopy and 79 patients
undergoing 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 and
performed a preoperative frozen section of sentinel nodes. Finally, complete lymphadenectomy
was done.
Results: There was one false – negative result in the group of 100 women. In the group of
tumors less than 20 mm the detection rate was 90.5% when laparoscopic detection was performed
and 91.7% in laparotomic detection. In tumors more than 20 mm the detection rate was
80% and in the group of 25 women with „bulky“ tumors IB2 after neoadjuvant chemotherapy
the detection was 60% only. We analysed locoregional distribution of 176 sentinel lymph nodes
in 75 women not undergoing neoadjuvant chemotherapy and distribution of 20 positive
sentinel nodes.
Conclusion: Detection of sentinel nodes in early stages of cervical carcinomas using patent blue dye
is a easy-to-perform, feasible and cheap method. Additional studies are necessary using radioisotope
to improve detection rate. Another prospective studies should evaluate the role of SNI in reduction
in surgical radicality.
Key words:
sentinel node, cervical cancer, patent blau, radicality
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