Skip to main content

Advertisement

SpringerLink
Log in

Usefulness of sentinel lymph node detection in early stages of cervical cancer

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Sentinel lymph node (SLN) mapping in combination with surgical biopsy is an emerging technique for use in the early stages of cervical cancer. The purpose of this study was to evaluate the technique in a series of 40 consecutive women with early stage cervical cancer.

Methods

Forty patients with early stage cervical cancer [FIGO stage IA2 (2), IB1 (34), IB2 (1) or IIA (3)] were referred for radical hysterectomy with pelvic lymphadenectomy. Patients were submitted to preoperative lymphoscintigraphy (four 99mTc-nanocolloid injections around the tumour) and intraoperative SLN detection. Hand-held or laparoscopic gamma probes were used to locate SLNs during surgery.

Results

The mean number of SLNs was 2.5 per patient (interiliac 49%, external iliac 19%). Of the total of 99 SLNs, six, in four women, showed metastases (all 68 non-SLNs removed were negative). In the other 36 patients, all the removed lymph nodes (sentinel and non-sentinel) were negative (0% false negative rate). During the follow-up (median 25 months), only two patients presented distant metastases: one died 6 months after surgery (two of three SLNs positive, both hot and blue), while the second patient is alive 4 years after surgery (lung metastasis, no isotope drainage, negative blue SLN). The survival rate was 95% and disease-free survival, 97%.

Conclusion

SLN surgical biopsy based on lymphoscintigraphy and blue dye is a feasible and useful technique to avoid lymph node dissection in the early stages of cervical cancer. It has a high negative predictive value, can be incorporated into clinical routine (laparoscopy or open surgery) and is close to achieving validation in this setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Cabanas RM. Anatomy and biopsy of sentinel lymph nodes. Urol Clin North Am 1992;19:267–76

    PubMed  Google Scholar 

  2. Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 1997;349:1864–7

    Article  CAS  PubMed  Google Scholar 

  3. Magrina JF, Goodrich MA, Lidner TK, Weaver AL, Cornella JL, Podratz KC. Modified radical hysterectomy in the treatment of early squamous cervical cancer. Gynecol Oncol 1999;72:183–6

    Article  CAS  PubMed  Google Scholar 

  4. Echt ML, Finan MA, Hoffman MS, Kline RC, Roberts WS, Fiorica JV. Detection of sentinel lymph node with lymphazurin in cervical, uterine, and vulvar malignancies. South Med J 1999;92:204–8

    CAS  PubMed  Google Scholar 

  5. Medl M, Peters-Engl C, Schutz P, Vesely M, Sevelda P. First report of lymphatic mapping with isosulfan blue dye and sentinel node biopsy in cervical cancer. Anticancer Res 2000;20:1133–4

    CAS  PubMed  Google Scholar 

  6. O’Boyle JD, Coleman RL, Bernstein SG, Lifshitz S, Muller CY, Miller DS. Intraoperative lymphatic mapping in cervix cancer patients undergoing radical hysterectomy: a pilot study. Gynecol Oncol 2000;79:238–43

    Article  CAS  PubMed  Google Scholar 

  7. Dargent D, Martin X, Mathevet P. Laparoscopic assessment of sentinel lymph node in early stage cervical cancer. Gynecol Oncol 2000;79:411–5

    Article  CAS  PubMed  Google Scholar 

  8. Verheijen RHM, Pijpers R, van Diest PJ, Burger CW, Buist MR, Kenemans P. Sentinel node detection in cervical cancer. Obstet Gynecol 2000;96:135–8

    Article  CAS  PubMed  Google Scholar 

  9. Kamprath S, Possover M, Schneider A. Laparoscopic sentinel lymph node detection in patients with cervical cancer. Am J Obstet Gynecol 2000;182:1648

    Article  CAS  Google Scholar 

  10. Malur S, Krause N, Köhler C, Schneider A. Sentinel lymph node detection in patients with cervical cancer. Gynecol Oncol 2001;80:254–7

    Article  CAS  PubMed  Google Scholar 

  11. Lantzsch T, Wolters M, Grimm J, Mende T, Buchmann J, Sliutz G, et al. Sentinel node procedure in Ib cervical cancer: a preliminary series. Br J Cancer 2001;85:791–4

    Article  CAS  PubMed  Google Scholar 

  12. Levenback C, Coleman RL, Burke TW, Lin WM, Erdman W, Deavers M, et al. Lymphatic mapping and sentinel node identification in patients with cervix cancer undergoing radical hysterectomy and pelvic lymphadenectomy. J Clin Oncol 2002;20:688–93

    Article  PubMed  Google Scholar 

  13. Rhim CC, Park JS, Bae SN, Namkoong SE. Sentinel node biopsy as an indicator for pelvic nodes dissection in early stage cervical cancer. J Korean Med Sci 2002;17:507–11

    PubMed  Google Scholar 

  14. Plante M, Renaud MC, Tetu B, Harel F, Roy M. Laparoscopic sentinel node mapping in early-stage cervical cancer. Gynecol Oncol 2003;91:494–503

    Article  CAS  PubMed  Google Scholar 

  15. Barranger E, Grahek D, Cortez A, Talbot JN, Uzan S, Darai E. Laparoscopic sentinel lymph node procedure using a combination of patent blue and radioisotope in women with cervical carcinoma. Cancer 2003;97:3003–9

    Article  PubMed  Google Scholar 

  16. Martinez-Palones JM, Gil-Moreno A, Perez-Benavente MA, Roca I, Xercavins J. Intraoperative sentinel node identification in early stage cervical cancer using a combination of radiolabeled albumin injection and isosulfan blue dye injection. Gynecol Oncol 2004;92:845–50

    Article  PubMed  Google Scholar 

  17. Lambaudie E, Collinet P, Narducci F, Sonoda Y, Papageorrgiou T, Carpentier P, et al. Laparoscopic identification of sentinel lymph nodes in early stage cervical cancer: prospective study using a combination of patent blue dye injection and technetium radiocolloid injection. Gynecol Oncol 2003;89:84–7

    Article  PubMed  Google Scholar 

  18. Chung Y, Kim SH, Sohn HS, Chung SK, Rhim CC, Namkoong SE. Usefulness of lymphoscintigraphy and intraoperative gamma probe detection in the identification of sentinel nodes in cervical cancer. Eur J Nucl Med Mol Imaging 2003;30:1014–7

    Article  PubMed  Google Scholar 

  19. Buist MR, Pijpers RJ, van Lingen A, van Diest PJ, Dijkstra J, Kenemans P, et al. Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer. Gynecol Oncol 2003;90:290–6

    Article  PubMed  Google Scholar 

  20. Barranger E, Cortez A, Commo F, Marpeau O, Uzan S, Darai E, et al. Histopathological validation of the sentinel node concept in cervical cancer. Ann Oncol 2004;15:870–4

    Article  CAS  PubMed  Google Scholar 

  21. Marchiole P, Buenerd A, Scoazec JY, Dargent D, Mathevet P. Sentinel lymph node biopsy is not accurate in predicting lymph node status for patients with cervical carcinoma. Cancer 2004;100:2154–9

    Article  PubMed  Google Scholar 

  22. Niikura H, Okamura C, Akahira J, Takano T, Ito K, Okamura K, et al. Sentinel lymph node detection in early cervical cancer with combination 99mTc phytate and patent blue. Gynecol Oncol 2004;94:528–32

    Article  PubMed  Google Scholar 

  23. Torné A, Puig-Tintore LM. The use of sentinel lymph nodes in gynaecological malignancies. Curr Opin Obstet Gynecol 2004;16:57–64

    PubMed  Google Scholar 

  24. Gil-Moreno A, Diaz-Feijoo B, Roca I, Puig O, Perez-Benavente MA, Aguilar I, et al. Total laparoscopic radical hysterectomy with intraoperative sentinel node identification in patients with early invasive cervical cancer. Gynecol Oncol 2005;96:187–93

    Article  PubMed  Google Scholar 

  25. Paredes P, Vidal-Sicart S, Garcia S, Pahisa J, Torne A, Ordi J, et al. Usefulness of the sentinel node in the treatment and staging of initial cervix cancer (in Spanish). Rev Esp Med Nucl 2004;23:253–8

    Article  CAS  PubMed  Google Scholar 

  26. Pijpers R, Buist MR, Van Lingen A, Dijkstra J, Van Diest PJ, Teule GJ, et al. The sentinel node in cervical cancer: scintigraphy and laparoscopic gamma probe-guided biopsy. Eur J Nucl Med Mol Imaging 2004;31:1479–86

    Article  PubMed  Google Scholar 

  27. Angioli R, Palaia I, Cipriani C, Muzii L, Calcagno M, Gullotta G, et al. Role of sentinel lymph node biopsy procedure in cervical cancer: a critical point of view. Gynecol Oncol 2005;96:504–9

    Article  PubMed  Google Scholar 

  28. Schneider A, Hertel H. Surgical and radiographic staging in patients with cervical cancer. Curr Opin Obstet Gynecol 2004;16:11–8

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Servei de Medicina Nuclear, Hospital Universitari Vall d’Hebron, 08035, Barcelona, Spain

    I. Roca, A. P. Caresia, P. Pifarre, S. Aguade-Bruix & J. Castell-Conesa

  2. Unit of Gynaecologic Oncology, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    A. Gil-Moreno, J. M. Martínez-Palones & J. Xercavins

Authors
  1. I. Roca
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. P. Caresia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Gil-Moreno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Pifarre
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Aguade-Bruix
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Castell-Conesa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. M. Martínez-Palones
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Xercavins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I. Roca.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roca, I., Caresia, A.P., Gil-Moreno, A. et al. Usefulness of sentinel lymph node detection in early stages of cervical cancer. Eur J Nucl Med Mol Imaging 32, 1210–1216 (2005). https://doi.org/10.1007/s00259-005-1834-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-005-1834-8

Keywords

Search

Navigation