Skip to main content

Advertisement

SpringerLink
Log in

Limits of Day-Before Lymphoscintigraphy to Localize Sentinel Nodes in Women with Cervical Cancer

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

Abstract

Background

Lymph node status in cervical cancer is a major prognostic factor. Sentinel lymph node (SN) biopsy using radiocolloid and blue dye labeling and preoperative lymphoscintigraphy has emerged as a potential alternative to systematic lymphadenectomy. The aim of this study was to evaluate the contribution of preoperative lymphoscintigraphy to SN biopsy.

Methods

Between April 2001 and December 2005, 71 of 77 patients with cervical cancer (38 patients with stages IA or IB1, and 39 patients with stage IB2, IIA or IIB) underwent laparoscopic SN procedure using radiocolloid and blue dye with day-before lymphoscintigraphy. The SN identification rates and false-negative rates were studied.

Results

Seventy patients underwent a combined technique and the last patient a radiocolloid technique alone due to blue dye allergic reaction. Detection rate of lymphoscintigraphy was 84.5% (60/71), with 1.4 sentinel nodes per patient. Three of 11 patients (27.3%) with no SN on lymphoscintigraphy had at least one SN during surgery. Sixteen of 27 patients (59.3%) with solitary SN on lymphoscintigraphy had multiple SNs. Nine of 35 patients (25.7%) with unilateral SNs on lymphoscintigraphy had bilateral SNs at surgery (kappa = 0.44 [0.19–0.64]). When categorized into <2 and ≥2 sentinel nodes, the correlation between lymphoscintigraphic and surgical detection was poor (kappa = 0.05 [0.0–0.18]).

Conclusions

SN biopsy is a feasible and accurate method to stage early cervical cancer. However, day-before lymphoscintigraphy is poorly correlated to surgical SN mapping.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Greenlee RT, Hill-Harmon MB, Murray T, et al. Cancer statistics. CA Cancer J Clin 2001; 51:15–36

    Article  PubMed  CAS  Google Scholar 

  2. Chou HH, Chang TC, Yen TC, et al. Low value of [18F]-fluoro-2-deoxy-D-glucose positron emission tomography in primary staging of early-stage cervical cancer before radical hysterectomy. J Clin Oncol 2006; 24:123–8

    Article  PubMed  Google Scholar 

  3. Sakuragi N, Satoh C, Takeda N, et al. Incidence and distribution pattern of pelvic and paraaortic lymph node metastasis in patients with stages IB, IIA, and IIB cervical carcinoma treated with radical hysterectomy. Cancer 1999; 85:1547–54

    Article  PubMed  CAS  Google Scholar 

  4. Michel G, Morice P, Castaigne D, et al. Lymphatic spread in stage Ib and II cervical carcinoma: anatomy and surgical implications. Obstet Gynecol 1998; 91:360–3

    Article  PubMed  CAS  Google Scholar 

  5. Magrina JF, Goodrich MA, Lidner TK, et al. Modified radical hysterectomy in the treatment of early squamous cervical cancer. Gynecol Oncol 1999; 72:183–6

    Article  PubMed  CAS  Google Scholar 

  6. Delgado G, Bundy BN, Fowler WC Jr, et al. Prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol 1989; 35:314–20

    Article  PubMed  CAS  Google Scholar 

  7. Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992; 127:392–9

    PubMed  CAS  Google Scholar 

  8. Schwartz GF, Giuliano AE, Veronesi U. Proceedings of the Consensus Conference on the Role of Sentinel Lymph Node Biopsy in Carcinoma of the Breast, April 19–22, 2001, Philadelphia, Pennsylvania. Cancer 2002; 94:2542–51

    Google Scholar 

  9. Levenback C, Burke TW, Gershenson DM, et al. Intraoperative lymphatic mapping for vulvar cancer. Obstet Gynecol 1994; 84:163–7

    PubMed  CAS  Google Scholar 

  10. De Hullu JA, Hollema H, Piers DA, et al. Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva. J Clin Oncol 2000; 18:2811–6

    PubMed  Google Scholar 

  11. Levenback C, Coleman RL, Burke TW, et al. Intraoperative lymphatic mapping and sentinel node identification with blue dye in patients with vulvar cancer. Gynecol Oncol 2001; 83:276–81

    Article  PubMed  CAS  Google Scholar 

  12. O’Boyle JD, Coleman RL, Bernstein SG, et al. Intraoperative lymphatic mapping in cervix cancer patients undergoing radical hysterectomy: a pilot study. Gynecol Oncol 2000; 79:238–43

    Article  PubMed  CAS  Google Scholar 

  13. Dargent D, Martin X, Mathevet P. Laparoscopic assessment of the sentinel lymph node in early stage cervical cancer. Gynecol Oncol 2000; 79:411–5

    Article  PubMed  CAS  Google Scholar 

  14. Levenback C, Coleman RL, Burke TW, et al. Lymphatic mapping and sentinel node identification in patients with cervix cancer undergoing radical hysterectomy and pelvic lymphadenectomy. J Clin Oncol 2002; 20:688–93

    Article  PubMed  Google Scholar 

  15. Verheijen RH, Pijpers R, van Diest PJ, et al. Sentinel node detection in cervical cancer. Obstet Gynecol 2000; 96:135–8

    Article  PubMed  CAS  Google Scholar 

  16. Kamprath S, Possover M, Schneider A. Laparoscopic sentinel lymph node detection in patients with cervical cancer. Am J Obstet Gynecol 2000; 182:1648

    Article  PubMed  CAS  Google Scholar 

  17. Malur S, Krause N, Kohler C, et al. Sentinel lymph node detection in patients with cervical cancer. Gynecol Oncol 2001; 80:254–7

    Article  PubMed  CAS  Google Scholar 

  18. Lantzsch T, Wolters M, Grimm J, et al. Sentinel node procedure in Ib cervical cancer: a preliminary series. Br J Cancer 2001; 85:791–4

    Article  PubMed  CAS  Google Scholar 

  19. Lambaudie E, Collinet P, Narducci F, et al. Laparoscopic identification of sentinel lymph nodes in early stage cervical cancer: prospective study using a combination of patent blue dye injection and technetium radiocolloid injection. Gynecol Oncol 2003; 89:84–7

    Article  PubMed  Google Scholar 

  20. Barranger E, Grahek D, Cortez A, et al. Laparoscopic sentinel lymph node procedure using a combination of patent blue and radioisotope in patients with cervical carcinoma. Cancer 2003; 97:3003–9

    Article  PubMed  Google Scholar 

  21. Plante M, Renaud MC, Tetu B, et al. Laparoscopic sentinel node mapping in early-stage cervical cancer. Gynecol Oncol 2003; 91:494–503

    Article  PubMed  CAS  Google Scholar 

  22. Dargent D, Enria R. Laparoscopic assessment of the sentinel lymph nodes in early cervical cancer. Technique-preliminary results and future developments. Crit Rev Oncol Hematol 2003; 48:305–10

    Article  PubMed  Google Scholar 

  23. Martinez-Palones JM, Gil-Moreno A, Perez-Benavente MA, et al. Intraoperative sentinel node identification in early stage cervical cancer using a combination of radiolabeled albumin injection and isosulfan blue dye injection. Gynecol Oncol 2004; 92:845–50

    Article  PubMed  Google Scholar 

  24. Barranger E, Cortez A, Grahek D, et al. Laparoscopic sentinel node procedure for cervical cancer: impact of neoadjuvant chemoradiotherapy. Ann Surg Oncol 2004; 11:445–52

    Article  PubMed  Google Scholar 

  25. Van Dam PA, Hauspy J, Vanderheyden T, et al. Intraoperative sentinel node identification with Technetium-99m-labeled nanocolloid in patients with cancer of the uterine cervix: a feasibility study. Int J Gynecol Cancer 2003; 13:182–6

    Article  PubMed  Google Scholar 

  26. Buist MR, Pijpers RJ, van Lingen A, et al. Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer. Gynecol Oncol 2003; 90:290–6

    Article  PubMed  Google Scholar 

  27. Niikura H, Okamura C, Akahira J, et al. Sentinel lymph node detection in early cervical cancer with combination 99mTc phytate and patent blue. Gynecol Oncol 2004; 94:528–32

    Article  PubMed  Google Scholar 

  28. Di Stefano AB, Acquaviva G, Garozzo G, et al. Lymph node mapping and sentinel node detection in patients with cervical carcinoma: a 2-year experience. Gynecol Oncol. 2005; 99:671–9

    Article  PubMed  Google Scholar 

  29. Frumovitz M, Coleman RL, Gayed IW, et al. Usefulness of preoperative lymphoscintigraphy in patients who undergo radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Am J Obstet Gynecol 2006; 194:1186–93; discussion 193–5

    Article  PubMed  Google Scholar 

  30. American Joint Committee on Cancer. Manual for Staging of Cancer, 4th edition. JB Lippincott: Philadelphia, PA 1992; 155–7

    Google Scholar 

  31. Barranger E, Coutant C, Cortez A, et al. Sentinel node biopsy is reliable in early-stage cervical cancer but not in locally advanced disease. Ann Oncol 2005; 16:1237–42

    Article  PubMed  CAS  Google Scholar 

  32. Mariani G, Moresco L, Viale G, et al. Radioguided sentinel lymph node biopsy in breast cancer surgery. J Nucl Med 2001; 42:1198–215

    PubMed  CAS  Google Scholar 

  33. Barranger E, Kerrou K, Pitre S, et al. Place of a hand-held gamma camera (POCI) in the breast cancer sentinel node biopsy. Breast 2007; 16:443–4

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, CancerEst, Université Pierre et Marie Curie, Paris 6, France

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

  2. Department of Nuclear Medicine and PET Center, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, CancerEst, Université Pierre et Marie Curie, Paris 6, France

    Khaldoun Kerrou MD, PhD

Authors
  1. Anne-Sophie Bats MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vincent Lavoué MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roman Rouzier MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Charles Coutant MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Khaldoun Kerrou MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emile Daraï MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emile Daraï MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bats, AS., Lavoué, V., Rouzier, R. et al. Limits of Day-Before Lymphoscintigraphy to Localize Sentinel Nodes in Women with Cervical Cancer. Ann Surg Oncol 15, 2173–2179 (2008). https://doi.org/10.1245/s10434-008-9897-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-008-9897-y

Keywords

Search

Navigation