| ORIGINAL ARTICLE |
|
| Year : 2017 | Volume
: 4
| Issue : 2 | Page : 9-15 |
|
|
Accuracy of detection rate and intraoperative sentinel lymph node assessment in early-stage cervical carcinoma
Begoña Díaz de la Noval1, Javier De Santiago Garcia1, Alicia Hernández Gutiérrez1, Ignacio Zapardiel Gutierrez1, Mariana Díaz Almirón2, Laura Yébenes Gregorio3, David Hardisson Hernaez3, María Dolores Diestro Tejeda1
1 Department of Gynecology Oncology Unit, Institute of Investigation, Madrid, Spain
2 Department of Biostatistics, Institute of Investigation, Madrid, Spain
3 Department of Pathology, Madrid, Spain
Correspondence Address:
Begoña Díaz de la Noval
Paseo de la Castellana 261, 28046 Madrid
Spain
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ami.ami_3_17
|
|
|
Objective: This article shows our experience on sentinel lymph node (SLN) biopsy in early-stage cervical carcinoma since the technique was introduced in our Institution. The main objective is to analyze the detection rate (DR) of metastatic SLNs, identifying prognostic factors for an increased risk of nodal metastases. Our second aim was to compare the accuracy of nodal metastases DR between intraoperative analysis and postoperative ultrastaging. Materials and Methods: Forty-one women with the International Federation of Gynecology and Obstetrics stages IA2-IIA1 who underwent laparoscopic surgical treatment applying the SLN technique, from December 2011 to June 2016, at La Paz University Hospital, were included. The sentinel node was identified using technetium and methylene blue dye or indocyanine green near-infrared fluorescent imaging, analyzed intraoperatively, and compared to deferred ultrastaging. Results: SLN DR was 100%, with a bilaterality rate of 83%. Twelve (26.8%) patients had metastatic nodes, 11 of them (91.7%) detected by SLN technique, of which 9 (81.8%) had only the sentinel node affected. False-negative rate was 2.4% after ultrastaging procedure. Metastatic SLN detection with ultrastaging was 45.5% higher than the intraoperative analysis, 63.6% of which had low tumor burden. The global detection of patients with nodal metastases after SLN technique was 21.9% higher than pelvic lymphadenectomy. Conclusions: Our preliminary results corroborate that SLN biopsy selectively maps metastatic nodes and ultrastaging increases the detection of metastatic SLNs, predominantly due to low tumor burden. |
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
