Introduction/Background In early FIGO stage patients (IA, IB1 and IIA1) nodal involvement is one of the most important prognostic factors. Pelvic lymphadenectomy (LDN) is performed in order to assess lymph node involvement. Sentinel lymph node (SLN) biopsy has been increasingly used with limited evidence of oncological safety.
Methodology Patients with FIGO stage IA1-IB1/IIA1 cervical carcinoma treated with radical surgery after lymph node assessment in Hospital Clinic (Barcelona, Spain) from 2001 to 2018 were included. Between 02/2001 and 05/2011 patients underwent SLN biopsy followed by complete pelvic LDN and patients from 06/2011 and 08/2018 underwent SLN dissection alone. Patients in whom SLN were detected unilaterally or not detected underwent a complete LDN of the failed mapped side. Radical surgery after intraoperative negative nodes were laparoscopic assisted vaginal radical hysterectomy or vaginal radical trachelectomy if fertility preservation desire. SLN were postoperative evaluated by pathologic ultrastaging. Intraoperative and postoperative as well as follow up data were prospectively recorded. STATA 15.1 was used for statistical analysis.
Results In 162 patients lymph node assessment was performed, 87 (53.7%) underwent SLN biopsy followed by pelvic bilateral LDN and 75 (46.3%) SLNB only. No differences regarding age at diagnosis, size of the tumor (≤2 cm vs >2 cm), FIGO stage or histology type were seen between both groups. 151 patients had negative nodes. From these patients, 7 patients (9.1%) recurred in the LDN group and 3 patients (4.3%) in the SLN group. Cox hazard ratios were not statistically significant for lymph node assessment group.
Conclusion Sentinel lymph node detection in patients with early cervical cancer does not entail an increased risk of recurrence with respect to the patients in whom a complete pelvic lymphadenectomy is performed.
Disclosure The authors have no relationships/conditions/circumstances that present a potential conflict of interest.
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