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Minerva Ginecologica 2020 Sep 03

DOI: 10.23736/S0026-4784.20.04634-1


language: English

Sentinel lymph node in cervical cancer: a literature review

Francesco PLOTTI, Giuseppe MESSINA , Corrado TERRANOVA, Roberto MONTERA, Carlo DE CICCO NARDONE, Federica GUZZO, Daniela LUVERO, Alessandra GATTI, Teresa SCHIRÓ, Gianmarco ROSSINI, Cristiana DE LUCA, Fernando FICAROLA, Laura FEOLE, Roberto ANGIOLI

Obstetrics and Gynecology, University Campus Biomedico of Rome, Rome, Italy


INTRODUCTION: Sentinel lymph node detection is a surgical procedure that allow to avoid systematic lymphadenectomy in those tumor in early stage where lymph node spread is not sure. If the Sentinel lymph node is not involved by tumour in 98-99% of case other lymph nodes are clean. The reason why less radical surgery is chosen is linked to the lower post-operative morbidity rate, the risk of lower limb lymphedema decreases. The aim of this review is to summarize what is the state of art of using the Sentinel Lymphnode Dissection (SLD) technique and what are the future goals to improve the safety and the reliability.
EVIDENCE ACQUISITION: We have conducted a review of the literature of the past 10 years to understand the attitudes of oncologist gynecologists in the world to the conservative treatment of cervical cancer. We only selected articles from 2010 onwards, which meet the inclusion criteria.
EVIDENCE SYNTHESIS: The detection rate varies from 83% to 100%. The bilateral detection rate, on the other hand, varies from% to 100%. The false negative rate ranges from 4% to 12%. Sensitivity varies from 20.7% (considering the frozen section) to 100%.
CONCLUSIONS: Indocyanine green is the most reliable and performing tracer for the search of the sentinel lymph node; that the false intraoperative negative rate is too high to be sure not to subject the patient to an incorrect therapeutic procedure; data concerning the safety and survival of conservative lymphadenectomy (SLND) compared to systematic lymphadenectomy are still lacking in the literature and therefore we are awaiting the results of the two ongoing randomized clinical trials that will allow us to have more significant scientific data.

KEY WORDS: Cervical cancer; Lymph node; Sentinel; Indocianine Green; ICG; Blue dye; Tc99m; Conservative surgery

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