Prognostic outcome and complications of sentinel lymph node navigation surgery for early-stage cervical cancer

• Published in: International journal of clinical oncology Vol. 23; no. 6; pp. 1167 - 1172
• Main Authors: Yahata, Hideaki, Kobayashi, Hiroaki, Sonoda, Kenzo, Kodama, Keisuke, Yagi, Hiroshi, Yasunaga, Masafumi, Ohgami, Tatsuhiro, Onoyama, Ichiro, Kaneki, Eisuke, Okugawa, Kaoru, Baba, Shingo, Isoda, Takuro, Ohishi, Yoshihiro, Oda, Yoshinao, Kato, Kiyoko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.12.2018; Springer Nature B.V
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Biopsy; Cancer Research; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Cervical cancer; Female; Humans; Hysterectomy; Hysterectomy - adverse effects; Lymph nodes; Lymphatic system; Medicine; Medicine & Public Health; Metastases; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Oncology; Organotechnetium Compounds; Original Article; Phytic Acid; Postoperative Complications; Prognosis; Radionuclide Imaging; Sentinel Lymph Node - diagnostic imaging; Sentinel Lymph Node - pathology; Sentinel Lymph Node - surgery; Sentinel Lymph Node Biopsy - adverse effects; Surgery; Surgery, Computer-Assisted - adverse effects; Surgical Oncology; Surgical outcomes; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Young Adult; Sentinel lymph node; Early cervical cancer; Sentinel node navigation surgery
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-018-1327-y

Background To evaluate the prognostic outcome and surgical complications in patients with early-stage cervical cancer who underwent sentinel node navigation surgery (SNNS) for hysterectomy or trachelectomy. Methods A total of 139 patients who underwent SNNS using 99m Tc phytate between 2009 and 2015 were evaluated. No further lymph node dissection was performed when intraoperative analysis of the sentinel lymph nodes (SLNs) was negative for metastasis. We compared the surgical complications between the SNNS group and 67 matched patients who underwent pelvic lymph node dissection (PLND) after SLN mapping between 2003 and 2008. We also examined the clinical outcomes in the SNNS group. Results The mean number of detected SLNs was 2.5 per patient. Fourteen of the 139 patients in the SNNS group underwent PLND based on the intraoperative SLN results. The amount of blood loss, the operative time, and the number of perioperative complications were significantly less in the SNNS group than in the matched PLND group. There was no recurrence during a follow-up period ranging from 2 to 88 months (median 40 months) in the SNNS group. Conclusions Using SNNS for early-stage cervical cancer is safe and effective and does not increase the recurrence rate. A future multicenter trial is warranted.