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Sentinel lymph node procedure followed by laparoscopic pelvic and paraaortic lymphadenectomy in women with IB2-II cervical cancer

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the contribution of the sentinel node (SN) procedure followed by pelvic and paraaortic lymphadenectomy to determine lymph node status in women with locally advanced cervical cancer.

Patients and methods

A total of 21 women with locally advanced cervical cancer underwent a first laparoscopic SN procedure and pelvic and paraaortic lymphadenectomy followed by concurrent chemoradiotherapy (CCR). Laparoscopic radical hysterectomy was performed after CCR when the pelvic and paraaortic nodes were not involved.

Results

SNs were detected by means of lymphoscintigraphy in 10 women (47.6%) and intra-operatively in 14 women (66.6%). Of the latter 14 patients, 9 (64%) had an involved SN and 1 of the remaining 5 had pelvic non-SN metastases. The SN false-negative rate was 10%. At final histology, 13 of the 21 women (62%) had lymph node metastases. The total number of recovered pelvic non-SNs was 262, and 10 nodes in 8 women were involved. The total number of paraaortic non-SNs was 255, and 2 nodes in 2 women were involved.

Conclusion

This study shows the poor correlation between pre-operative lymphoscintigraphy and surgical SN mapping in women with locally advanced cervical cancer. A high proportion of women had SN metastases, underlining the importance of multiple sectioning and immunohistochemical staining of SNs.

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Acknowledgements

We thank Alain Toledano and Emmanuel Touboul (Department of radiotherapy) for their contribution to the manuscript.

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Authors and Affiliations

  1. Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, CancerEst, Université Pierre et Marie Curie, Paris VI, France

    Vincent Lavoué MD, Anne-Sophie Bats MD, Roman Rouzier MD, PhD, Charles Coutant MD, Emmanuel Barranger MD & Emile Daraï MD, PhD

  2. Service de Gynécologie-Obstétrique, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France

    Emile Daraï MD, PhD

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  1. Vincent Lavoué MD
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  2. Anne-Sophie Bats MD
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  3. Roman Rouzier MD, PhD
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  4. Charles Coutant MD
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  5. Emmanuel Barranger MD
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  6. Emile Daraï MD, PhD
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Correspondence to Emile Daraï MD, PhD.

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Lavoué, V., Bats, AS., Rouzier, R. et al. Sentinel lymph node procedure followed by laparoscopic pelvic and paraaortic lymphadenectomy in women with IB2-II cervical cancer. Ann Surg Oncol 14, 2654–2661 (2007). https://doi.org/10.1245/s10434-007-9493-6

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  • DOI: https://doi.org/10.1245/s10434-007-9493-6

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