Skip to main content
SpringerLink
Log in

Sentinel Lymph Node Mapping in the Management of Cervical Cancer

  • Chapter
  • First Online:
Book cover Pelvic Cancer Surgery

  • 1949 Accesses

Abstract

Regional lymph node status is the most important prognostic factor for survival in patients with early cervical cancer. Pelvic lymph node dissections are routinely performed as part of standard surgical treatment. Systematic pelvic lymphadenectomy is associated with short- and long-term morbidities. The chapter discusses single components of sentinel lymph node mapping (SLNM) and results related to the detection of sentinel lymph nodes. SLNM biopsy performed by an experienced team for small volume tumors (<2 cm) has a high specific side detection rate, excellent negative predictive value and high sensitivity. Uncommon lymphatic drainage has been reported in 15 % of cervical cancer patients. There is sufficient data now to suggest that SLNM with 99mTc in combination with blue dye in the hands of a skilled, experienced surgeon should prove highly useful in individualized cervical cancer surgery and as a viable option to increase the safety of less radical fertility-sparing surgery.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arbyn M, Castellsague X, Sanjose S, Bruni L, Saraiya M, Bray F, et al. Worldwide burden of cervical cancer in 28. Ann Oncol. 2011;22:2675–86.

    Article  CAS  PubMed  Google Scholar 

  2. Watson M, Saraiya M, Benard V. Burden of cervical cancer in the United States, 1998–2003. Cancer. 2008;113 Suppl 10:2855–64.

    Article  PubMed  Google Scholar 

  3. Rob L, Skapa P, Robova H. Fertility–sparing surgery in patients with cervical cancer. Lancet Oncol. 2011;12:192–200.

    Article  PubMed  Google Scholar 

  4. Rob L, Halaska M, Robova H. Nerve—sparing and individually tailored surgery for cervical cancer. Lancet Oncol. 2010;11(3):292–301.

    Article  PubMed  Google Scholar 

  5. Undurraga M, Loubeyre P, Dubuisson JB, Schneider D, Petignat P. Early-stage cervical cancer: is surgery better than radiotherapy? Expert Rev Anticancer Ther. 2010;10(3):451–60.

    Article  PubMed  Google Scholar 

  6. Vrzackova P, Weiss P, Cibula D. Sexual morbidity following radical hysterectomy for cervical cancer. Expert Rev Anticancer Ther. 2010;10(7):1037–42.

    Article  CAS  PubMed  Google Scholar 

  7. Zivanovic O, Leitao MM, Park JK, Zhao H, Diaz JP, Konner J, et al. Small cell neuroendocrine carcinoma of the cervix: analysis of outcome, recurrence pattern and the impact of platinum-based combination chemotherapy. Gynecol Oncol. 2009;112(3):590–3.

    Article  CAS  PubMed  Google Scholar 

  8. De Souza NM, Dina R, McIndoe GA, Soutter WP. Cervical cancer: value of an endovaginal coil magnetic resonance imaging technique in detecting small volume disease and assessing parametrial extension. Gynecol Oncol. 2006;102(1):80–5.

    Article  Google Scholar 

  9. Sahdev A, Sohaib SA, Wenaden AE, Shepard JH, Reznek RH. The performance of magnetic resonance imaging in early cervical carcinoma: a long-term experience. Int J Gynecol Cancer. 2007;17(3):629–36.

    Article  CAS  PubMed  Google Scholar 

  10. Fischerova D, Cibula D, Stehnova H, Vondrickova H, Calda P, Zikan M, et al. Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer. Int J Gynecol Cancer. 2008;18:766–72.

    Article  CAS  PubMed  Google Scholar 

  11. Rob L, Robova H, Chmel R, Komar M, Halaska M, Skapa P. Surgical options in early cervical cancer. Int J Hyperthermia. 2012;28(6):489–500.

    Article  PubMed  Google Scholar 

  12. Selman TJ, Mann C, Zamora J, Appleyard TL, Khan K. Diagnostic accuracy of test for lymph node status in primary cervical cancer: a systematic review and meta-analysis. CMAJ. 2008;178(7):855–62.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Wright JD, Dehdashti F, Herzog TJ, Much DG, Huettner PC, Rader JS, et al. Preoperative lymph node staging of early—stage cervical carcinoma by /18F/–fluoro-2-deoxy-D-glucose-positron emission tomography. Cancer. 2005;104(11):2484–91.

    Article  PubMed  Google Scholar 

  14. Signorelli M, Guerra L, Montanelli L, Crivellaro C, Buda A, Dell AT, et al. Preoperative staging of cervical cancer: is 18-FDG-PET/CT really effective with early stage disease? Gynecol Oncol. 2011;123:236–40.

    Article  PubMed  Google Scholar 

  15. Levenback CF, van der Zee AG, Rob L, Plante M, Covens A, Schneider A, et al. Sentinel lymph node biopsy in patients with gynaecologic cancers. Expert panel statement from the International Sentinel Node Society Meeting, February 21, 2008. Gynecol Oncol. 2009;114:151–6.

    Article  PubMed  Google Scholar 

  16. Plante M, Renaud MC, Tetu B, Harel F, Roy M. Laparoscopic sentinel node mapping in early- stage cervical cancer. Gynecol Oncol. 2003;91(3):494–503.

    Article  CAS  PubMed  Google Scholar 

  17. Rob L, Strnad P, Robova H, Charvat M, Pluta M, Schlegerova D, et al. Study of lymphatic mapping and sentinel node identification in early stage cervical cancer. Gynecol Oncol. 2005;98:281–8.

    Article  PubMed  Google Scholar 

  18. Marnitz S, Köhler C, Bongardt S, Braig U, Hertel H, Schneider A. Topographic distribution of sentinel lymph nodes in patients with cervical cancer. Gynecol Oncol. 2006;103:35–44.

    Article  PubMed  Google Scholar 

  19. Altgassen C, Hertel H, Brandstädt A, Kohler C, Durst M, Schneider A. Multicenter validation study of the sentinel lymph node concept in cervical cancer: AGO study group. J Clin Oncol. 2008;26:2943–51.

    Article  PubMed  Google Scholar 

  20. Lécuru F, Mathevet P, Querleu D, Leblanc E, Mirice P, Darai E. Bilateral negative sentinel nodes accurately predict absence of lymph node metastasis in early cervical cancer: results of the SENTICOL study. J Clin Oncol. 2011;29(13):1686–91.

    Article  PubMed  Google Scholar 

  21. Slama J, Dundr P, Dusek L, Fischerova D, Pinkavova I, Zikan M, et al. Sentinel lymph node status in patients with locally advanced cervical cancers and impact of neoadjuvant chemotherapy. Gynecol Oncol. 2012;125(2):303–6.

    Article  CAS  PubMed  Google Scholar 

  22. Cormier B, Diaz JP, Shih K, Samson RM, Sonoda Y, Park KJ, et al. Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecol Oncol. 2011;122(2):275–80.

    Article  PubMed  Google Scholar 

  23. Roy M, Bouchard-Fortier G, Popa I, Grégorie J, Renaud MC, Tetu B, et al. Value of sentinel node mapping in cancer of the cervix. Gynecol Oncol. 2011;122(2):269–74.

    Article  PubMed  Google Scholar 

  24. Euscher ED, Malpica A, Atkinson EN, Lavenback CF, Frumovitz M, Deavers MT. Ultrastaging improves detection of metastases in sentinel lymph nodes of uterine cervix squamous cell carcinoma. Am J Surg Pathol. 2008;32(9):1336–43.

    Article  PubMed  Google Scholar 

  25. Bricou A, Barranger E, Uzan S, Darai E. Anaphylactic shock during the sentinel lymph node procedure for cervical cancer. Gynecol Oncol. 2009;114(2):375–6.

    Article  PubMed  Google Scholar 

  26. Vieira SC, Sousa RB, Tavares MB, Abreu BA, Ibia Pina JO, Sousa Oliveira AK. Changes in pulse oximetry after patent blue dye injection into the uterine cervix. Ann Surg Oncol. 2008;15(10):2862–6.

    Article  PubMed  Google Scholar 

  27. Pluta M, Rob L, Charvat M, Chmel R, Halaska M, Skapa P, et al. Less radical surgery than radical hysterectomy in early stage cervical cancer: a pilot study. Gynecol Oncol. 2009;113(2):181–4.

    Article  PubMed  Google Scholar 

  28. Darlin L, Persson J, Bossmar T, Lindahl B, Kannisto P, Masback A, et al. The sentinel node concept in early cervical cancer performs well in tumors smaller than 2 cm. Gynecol Oncol. 2010;117(2):266–9.

    Article  PubMed  Google Scholar 

  29. Kato H, Todo Y, Minobe S, Suzuki Y, Nakatani M, Ohba Y, et al. Previous conization on patient eligibility of sentinel lymph node detection for early invasive cervical cancer. Int J Gynecol Cancer. 2011;21(8):1491–4.

    Article  PubMed  Google Scholar 

  30. Gortzak-Uzan L, Jimenez W, Nofech-Mozes S, Ismiil N, Khalifa MA, Dubé V, et al. Sentinel lymph node biopsy vs. pelvic lymphadenectomy in early stage cervical cancer: is it time to change the gold standard? Gynecol Oncol. 2010;116(1):28–32.

    Article  CAS  PubMed  Google Scholar 

  31. Bats AS, Lavoué V, Rouzier R, Coutant C, Kerrou K, Darai E. Limits of day-before lymphoscintigraphy to localize sentinel nodes in women with cervical cancer. Ann Surg Oncol. 2008;15(8):2173–9.

    Article  PubMed  Google Scholar 

  32. Bats AS, Lavoué V, Barranger E, Daraï E. Is preoperative lymphoscintigraphy for sentinel node in cervical cancer required? Am J Obstet Gynecol. 2007;197(1):116.

    Article  PubMed  Google Scholar 

  33. Vieira SC, Sousa RB, Tavares MB, Silva JB, Abreu BA, Santos LG, et al. Preoperative pelvic lymphoscintigraphy is of limited usefulness for sentinel lymph node detection in cervical cancer. Eur J Obstet Gynecol Reprod Biol. 2009;145(1):96–9.

    Article  PubMed  Google Scholar 

  34. Gien LT, Covens A. Quality control in sentinel lymph node biopsy in cervical cancer. J Clin Oncol. 2008;26(18):2930–1.

    Article  PubMed  Google Scholar 

  35. Devaja O, Mehra G, Coutts M, Montalto SA, Donaldson J, Kodampur M, et al. A prospective single-center study of sentinel lymph node detection in cervical carcinoma: is there a place in clinical practice? Int J Gynecol Cancer. 2012;22(6):1044–9.

    Article  PubMed  Google Scholar 

  36. Cibula D, Abu-Rustum NR, Dusek L, Zikan M, Zaal A, Sevcik L, et al. Prognostic significance of low volume sentinel lymph node disease in early-stage cervical cancer. Gynecol Oncol. 2012;124(3):496–501.

    Article  CAS  PubMed  Google Scholar 

  37. Bats AS, Buénerd A, Querleu D, Leblanc E, Darai E, Morice P, et al. SENTICOL collaborative group. Diagnostic value of intraoperative examination of sentinel lymph node in early cervical cancer: a prospective, multicenter study. Gynecol Oncol. 2011;123(2):230–5.

    Article  PubMed  Google Scholar 

  38. Fader AN, Edwards RP, Cost M, Kanbour-Shakir A, Kelley JL, Schwartz B, et al. Sentinel lymph node biopsy in early-stage cervical cancer: utility of intraoperative versus postoperative assessment. Gynecol Oncol. 2008;111(1):13–7.

    Article  PubMed  Google Scholar 

  39. Okamoto S, Niikura H, Yoshinaga K, Satoshi MT, Hitoshi MD, Kosuke MD, et al. Detection of micrometastases in cervical cancer with a system that evaluates both sentinel and nonsentinel lymph nodes. Int J Gynecol Cancer. 2009;19(4):708–11.

    Article  PubMed  Google Scholar 

  40. Wydra D, Sawicki S, Wojtylak S, Bandurski T, Emerich J. Sentinel node identification in cervical cancer patients undergoing transperitoneal radical hysterectomy: a study of 100 cases. Int J Gynecol Cancer. 2006;16:649–54.

    Article  CAS  PubMed  Google Scholar 

  41. Horn LC, Hentschel B, Fischer U, Peter D, Bilek K. Detection of micrometastases in pelvic lymph nodes in patients with carcinoma of the cervix uteri using step sectioning: frequency, topographic distribution and prognostic impact. Gynecol Oncol. 2008;111(2):276–81.

    Article  PubMed  Google Scholar 

  42. Popa I, Plante M, Renaud MC, Roy M, Tetu B. Negative sentinel lymph node accurately predicts negative status of pelvic lymph nodes in uterine cervix carcinoma. Gynecol Oncol. 2006;103(2):649–53.

    Article  PubMed  Google Scholar 

  43. Rob L, Pluta M, Skapa P, Robova H. Advances in fertility-sparing surgery for cervical cancer. Expert Rev Anticancer Ther. 2010;10(7):1101–14.

    Article  PubMed  Google Scholar 

  44. Rob L, Charvat M, Robova H, Pluta M, Strnad P, Hrehorcak M, et al. Less radical fertility-sparing surgery than radical trachelectomy in early cervical cancer. Int J Gynecol Cancer. 2007;17(1):304–10.

    Article  CAS  PubMed  Google Scholar 

  45. Rob L, Pluta M, Strnad P, Hrehorcak M, Chmel R, Skapa P, et al. A less radical treatment option to the fertility-sparing radical trachelectomy in patients with stage I cervical cancer. Gynecol Oncol. 2008;111:S116–20.

    Article  PubMed  Google Scholar 

  46. Daraï E, Lavoué V, Rouzier R, Coutant C, Barranger E, Bats AS. Contribution of the sentinel node procedure to tailoring the radicality of hysterectomy for cervical cancer. Gynecol Oncol. 2007;106(1):251–6.

    Article  PubMed  Google Scholar 

  47. Frumovitz M, Ramirez PT, Levenback CF. Lymphatic mapping and sentinel lymph node detection in women with cervical cancer. Gynecol Oncol. 2008;110(3 Suppl 2):S17–20.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, 2nd Medical Faculty, Charles University, Prague, Czech Republic

    Lukas Rob MD, PhD

Authors
  1. Lukas Rob MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lukas Rob MD, PhD .

Editor information

Editors and Affiliations

  1. Urology, University Hospital of North Norway, Tromsø, Norway

    Hitendra R.H. Patel

  2. University College London Hospital, London, United Kingdom

    Tim Mould

  3. Laparoscopic and Robotic Surgery, University of Rochester Medical Center, Rochester, New York, USA

    Jean V. Joseph

  4. Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Conor P. Delaney

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Rob, L. (2015). Sentinel Lymph Node Mapping in the Management of Cervical Cancer. In: Patel, H., Mould, T., Joseph, J., Delaney, C. (eds) Pelvic Cancer Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4258-4_34

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4258-4_34

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4257-7

  • Online ISBN: 978-1-4471-4258-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation