Lymphatic Mapping and Detection of Sentinel Node in Early Stages of Cervical Carcinoma

Overview

Objective:
The aim of the study was to analyse two methods of intraoperative sentinel node detection using blue dye and blue dye with Tc99 labeled tracer in early stage of the cervical cancer.

Design:
Prospective case observational study.

Setting:
Department of Obstetrics and Gynecology, University Hospital Ostrava

Methods:
From May 2004 to September 2005, 49 patients with cervical cancer who underwent a radical surgery were included into the study. Sentinel lymph node was detected using blue dye in the first group of 23 patients and by blue dye with Tc⁹⁹ in the second group of 26 patients. Intraoperative sentinel node detection was performed by visual aspection in the first group, and by visual aspection and by hand-held gamma-probe in the second group.

Results:
Patients were divided according to stage of the disease into three subgroups FIGO IA2, FIGO IB1 and FIGO IB2. A total number of 1561 lymph node with an average 32 and 94 SLN with an average 1.9 were identified. The specific detection rate per site was 63% in the first group and 80.8% in the second group respectively. Metastatic disease was detected in 26 patients (41%) and metastatic involvement of SLN only in 11 patients (17,4%). Sensitivity and negative predictive value were 100% in both groups, false negativity was 0%.

Conclusion:
Detection of SLN by combination of blue dye and Tc⁹⁹ labeled tracer has a higher detection rate of SLN than detection by blue dye alone.

Key words:
cervical cancer, sentinel node, radical surgery