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Utility of Sentinel Node Biopsy in Cervical Cancer

  • Alejandra Mateos
  • Silvia Marín
  • Ignacio Zapardiel
Chapter

Abstract

The sentinel node is defined as the first lymph node to receive drainage from the tumor. The stage at diagnosis and lymph node involvement in cervical cancer are the two most important prognostic factors. The lymph node state will not only define prognosis but also determine the treatment. The most recognized procedure to evaluate the lymph node status is the pelvic lymphadenectomy, which is not free of short- and long-term complications. Therefore, the applicability of sentinel node biopsy in cervical cancer has recently begun to be studied.

Many factors are involved in the sensitivity and specificity of this technique, such as the patient’s age, tumor size, surgeon’s experience, approach, substance used for mapping, and pathological analysis method. Different substances – traditionally blue dyes and radiotracer, alone or combined – have been used for the detection of the sentinel node, resulting in a better detection rate when used together. Radiotracers allow preoperative imaging, which may decrease surgery time. Recently, the indocyanine green technique (a fluorescent dye) has been developed in a way to allow for real-time imaging during surgery, demonstrating better overall and bilateral detection rates. The histological study is performed intraoperatively because it modifies the therapeutic attitude. With sentinel node biopsy, ultrastaging analysis can be performed to detect micrometastasis and isolated tumoral cells. In addition, the sentinel node has other advantages over the lymphadenectomy, such as the detection of lymph node in atypical locations and the possibility of detecting low tumor volume. Based on evidence to date, the 2015 edition of National Comprehensive Cancer Network includes node mapping in early-stage cervical cancer.

Keywords

Cervical cancer Sentinel lymph node biopsy Lymphatic mapping Lymph node status Cervical uterine cancer Sentinel lymph node biopsy 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alejandra Mateos
    • 1
  • Silvia Marín
    • 1
  • Ignacio Zapardiel
    • 2
  1. 1.Gynecologic Oncology UnitLa Paz University HospitalMadridSpain
  2. 2.Gynecologic Oncology UnitLa Paz University Hospital-IdiPAZMadridSpain

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