Abstract
The aim of this study was to determine the diagnostic accuracy and feasibility of sentinel lymph node (SLN) detection using a gamma probe in patients with Figo IB cervical cancer. Between January 1999 and September 2000, 14 patients with cervical cancer, planned for radical hysterectomy were eligible for the study. The day before radical hysterectomy we injected technetium99m-labelled nanocolloid in each quadrant of the cervix. Dynamic and static images were recorded using a gamma camera. SLNs were identified intraoperatively using a handheld gamma-detection probe. After resection of SLNs a standard radical hysterectomy with pelvic lymph node dissection was performed. Patients and tumour characteristics were compared with sentinel node detection and with final histopathological and immunohistochemical results. Scintigraphy showed focal uptake in 13 of the 14 patients. Intraoperatively we detected 26 sentinel nodes by gamma probe. In 8 of 13 patients, one or more sentinel nodes were identified unilaterally, in 5 women bilaterally. Histologically positive SLNs were found in only 1 patient. We did not find any false-negative SLN in our series. In conclusion identification of sentinel nodes in cervical cancer is feasible with preoperatively administered technetium99m-labelled nanocolloid. A larger series will be required to establish sentinel node detection in cervical cancer for further therapy concepts and planning. © 2001 Cancer Research Campaignhttp://www.bjcancer.com
Keywords: sentinel lymph node; cervical cancer; lymphoscintigraphy, lymphatic mapping
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- Benedetti-Panici P., Maneschi F., Scambia G., Greggi S., Cutillo G., D'Andrea G., Rabitti C., Coronetta F., Capelli A., Mancuso S. Lymphatic spread of cervical cancer: an anatomical and pathological study based on 225 radical hysterectomies with systematic pelvic and aortic lymphadenectomy. Gynecol Oncol. 1996 Jul;62(1):19–24. doi: 10.1006/gyno.1996.0184. [DOI] [PubMed] [Google Scholar]
- Cabanas R. M. An approach for the treatment of penile carcinoma. Cancer. 1977 Feb;39(2):456–466. doi: 10.1002/1097-0142(197702)39:2<456::aid-cncr2820390214>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
- Dargent D., Martin X., Mathevet P. Laparoscopic assessment of the sentinel lymph node in early stage cervical cancer. Gynecol Oncol. 2000 Dec;79(3):411–415. doi: 10.1006/gyno.2000.5999. [DOI] [PubMed] [Google Scholar]
- Echt M. L., Finan M. A., Hoffman M. S., Kline R. C., Roberts W. S., Fiorica J. V. Detection of sentinel lymph nodes with lymphazurin in cervical, uterine, and vulvar malignancies. South Med J. 1999 Feb;92(2):204–208. doi: 10.1097/00007611-199902000-00008. [DOI] [PubMed] [Google Scholar]
- Gershenwald J. E., Thompson W., Mansfield P. F., Lee J. E., Colome M. I., Tseng C. H., Lee J. J., Balch C. M., Reintgen D. S., Ross M. I. Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients. J Clin Oncol. 1999 Mar;17(3):976–983. doi: 10.1200/JCO.1999.17.3.976. [DOI] [PubMed] [Google Scholar]
- Giuliano A. E., Kirgan D. M., Guenther J. M., Morton D. L. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994 Sep;220(3):391–401. doi: 10.1097/00000658-199409000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kamprath S., Possover M., Schneider A. Laparoscopic sentinel lymph node detection in patients with cervical cancer. Am J Obstet Gynecol. 2000 Jun;182(6):1648–1648. doi: 10.1067/mob.2000.104144. [DOI] [PubMed] [Google Scholar]
- Levenback C., Burke T. W., Gershenson D. M., Morris M., Malpica A., Ross M. I. Intraoperative lymphatic mapping for vulvar cancer. Obstet Gynecol. 1994 Aug;84(2):163–167. [PubMed] [Google Scholar]
- Magrina J. F., Goodrich M. A., Lidner T. K., Weaver A. L., Cornella J. L., Podratz K. C. Modified radical hysterectomy in the treatment of early squamous cervical cancer. Gynecol Oncol. 1999 Feb;72(2):183–186. doi: 10.1006/gyno.1998.5245. [DOI] [PubMed] [Google Scholar]
- Medl M., Peters-Engl C., Schütz P., Vesely M., Sevelda P. First report of lymphatic mapping with isosulfan blue dye and sentinel node biopsy in cervical cancer. Anticancer Res. 2000 Mar-Apr;20(2B):1133–1134. [PubMed] [Google Scholar]
- Morton D. L., Wen D. R., Wong J. H., Economou J. S., Cagle L. A., Storm F. K., Foshag L. J., Cochran A. J. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992 Apr;127(4):392–399. doi: 10.1001/archsurg.1992.01420040034005. [DOI] [PubMed] [Google Scholar]
- O'Boyle J. D., Coleman R. L., Bernstein S. G., Lifshitz S., Muller C. Y., Miller D. S. Intraoperative lymphatic mapping in cervix cancer patients undergoing radical hysterectomy: A pilot study. Gynecol Oncol. 2000 Nov;79(2):238–243. doi: 10.1006/gyno.2000.5930. [DOI] [PubMed] [Google Scholar]
- Scheidler J., Hricak H., Yu K. K., Subak L., Segal M. R. Radiological evaluation of lymph node metastases in patients with cervical cancer. A meta-analysis. JAMA. 1997 Oct 1;278(13):1096–1101. [PubMed] [Google Scholar]
- Shingleton H. M. Surgery for cervical cancer: a time for reassessment. Gynecol Oncol. 1998 Apr;69(1):8–13. doi: 10.1006/gyno.1998.4957. [DOI] [PubMed] [Google Scholar]
- Verheijen R. H., Pijpers R., van Diest P. J., Burger C. W., Buist M. R., Kenemans P. Sentinel node detection in cervical cancer. Obstet Gynecol. 2000 Jul;96(1):135–138. doi: 10.1016/s0029-7844(00)00831-0. [DOI] [PubMed] [Google Scholar]
- de Hullu J. A., Doting E., Piers D. A., Hollema H., Aalders J. G., Koops H. S., Boonstra H., van der Zee A. G. Sentinel lymph node identification with technetium-99m-labeled nanocolloid in squamous cell cancer of the vulva. J Nucl Med. 1998 Aug;39(8):1381–1385. [PubMed] [Google Scholar]
- de Hullu J. A., Hollema H., Piers D. A., Verheijen R. H., van Diest P. J., Mourits M. J., Aalders J. G., van Der Zee A. G. Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva. J Clin Oncol. 2000 Aug;18(15):2811–2816. doi: 10.1200/JCO.2000.18.15.2811. [DOI] [PubMed] [Google Scholar]