[Sentinel lymph nodes detection in patients with cervical cancer undergoing radical hysterectomy].
Hua-ying Wang, Jian-min Sun, Jie Tang
Abstract
Hua-ying Wang, Jian-min Sun, Jie Tang
Abstract
OBJECTIVE: To investigate the feasibility of sentinel lymph node (SLN) detection in patients with cervical cancer undergoing radical hysterectomy. METHODS: Twenty patients with cervical cancer at stage Ib (n = 3), stage IIa (n = 12) and stage IIb (n = 5) underwent SLNs detection by using blue dye. Four ml of methylene blue or lymphazurin was injected into the cervix at 4 points around the tumor at the time of radical hysterectomy and bilateral pelvic lymphadenectomy. Tumor characteristics, surgical findings, and specific locations of lymphatic dye uptake were recorded and correlated with final pathology results. RESULTS: Among 20 patients underwent this detection, dye uptake was seen in 18 patients. Total number of SLNs were 33. Eighteen SLNs identified located in right pelvic and 15 SLNs located in left. The SLNs were successfully detected in 78% patients (14/18). Six patients (33%) were diagnosed with lymph node metastases and there were 5 patients with positive nodes in the group of SLN. Two patients had both positive SLNs and pelvic lymph nodes. Three patients had positive SLNs only. The predictive rate was 100% and the false-negative rate was zero. CONCLUSION: SLN detection undergoing radical hysterectomy is feasible and safe, however, the detection rate of SLN needs improvement.
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OBJECTIVE: To investigate the feasibility of sentinel lymph node (SLN) detection in patients with cervical cancer undergoing radical hysterectomy. METHODS: Twenty patients with cervical cancer at stage Ib (n = 3), stage IIa (n = 12) and stage IIb (n = 5) underwent SLNs detection by using blue dye. Four ml of methylene blue or lymphazurin was injected into the cervix at 4 points around the tumor at the time of radical hysterectomy and bilateral pelvic lymphadenectomy. Tumor characteristics, surgical findings, and specific locations of lymphatic dye uptake were recorded and correlated with final pathology results. RESULTS: Among 20 patients underwent this detection, dye uptake was seen in 18 patients. Total number of SLNs were 33. Eighteen SLNs identified located in right pelvic and 15 SLNs located in left. The SLNs were successfully detected in 78% patients (14/18). Six patients (33%) were diagnosed with lymph node metastases and there were 5 patients with positive nodes in the group of SLN. Two patients had both positive SLNs and pelvic lymph nodes. Three patients had positive SLNs only. The predictive rate was 100% and the false-negative rate was zero. CONCLUSION: SLN detection undergoing radical hysterectomy is feasible and safe, however, the detection rate of SLN needs improvement.
Key concepts: Radical Hysterectomy, Medicine, Lymph, Cervical cancer, Sentinel lymph node, Stage (stratigraphy), Cervix, Lymph node