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OP001/#162 Sentinel lymph node mapping in early-stage cervical cancer – a national prospective multicenter study (sentirec trial)
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  1. S Sponholtz1,2,
  2. O Mogensen3,4,
  3. M Hildebrandt2,5,6,
  4. D Schledermann2,7,
  5. E Parner8,
  6. A Markauskas1,
  7. L Frøding9,
  8. K Fuglsang3,
  9. M Vilstrup5,
  10. S Bjørnholt3,4 and
  11. P Jensen2,3,4
  1. 1Odense University Hospital, Department of Gynecology and Obstetrics, Odense C, Denmark
  2. 2University of Southern Denmark, Department of Clinical Research, Odense C, Denmark
  3. 3Aarhus University Hospital, Department of Gynecology and Obstetrics, Aarhus N, Denmark
  4. 4Aarhus University, Institute of Clinical Medicine, Aarhus, Denmark
  5. 5Odense University Hospital, Department of Nuclear Medicine, Odense C, Denmark
  6. 6Odense University Hospital and University of Southern Denmark, Center For Innovative Medical Technology, Odense C, Denmark
  7. 7Odense University Hospital, Department of Pathology, Odense C, Denmark
  8. 8Aarhus University, Department of Public Health, Aarhus, Denmark
  9. 9Copenhagen University Hospital, Department of Gynecology, Copenhagen, Denmark

Abstract

Objectives Sentinel lymph node (SLN) mapping may replace staging radical pelvic lymphadenectomy in women with early-stage cervical cancer. In a national multicenter setting, we evaluated SLN mapping in women with early-stage cervical cancer and investigated the accuracy of SLN mapping and FDG-PET/CT in tumors >20 mm.

Methods We prospectively included women with early-stage cervical cancer from March 2017-January 2021 to undergo SLN mapping. Women with tumors >20 mm underwent completion pelvic lymphadenectomy and removal of FDG-PET/CT positive nodes. We determined SLN detection rates, incidence of nodal disease, sensitivity and negative predictive value (NPV) of SLN mapping, and the sensitivity, specificity, NPV, and positive predictive value (PPV) of FDG-PET/CT.

Results We included 245 women, and 38 (15.5%) had nodal metastasis. The SLN detection rate was 96.3% (236/245), with 82.0% (201/245) bilateral detection. In a stratified analysis of 103 women with tumors >20 mm, 27 (26.2%) had nodal metastases. The sensitivity of SLN mapping adhering to the algorithm was 96.3% (95% CI 81.0–99.9%) and the NPV 98.7% (95% CI 93.0–100%). For FDG-PET/CT imaging the sensitivity was 14.8% (95% CI 4.2–33.7%), the specificity 85.5% (95% CI 75.6–92.5%), the NPV 73.9% (95% CI 63.4–82.7%), and the PPV 26.7% (95% CI 7.8–55.1%).

Conclusions Our results suggest that SLN mapping is a reliable method in women with early-stage cervical cancer. However, until the oncological safety is established, we recommend completion pelvic lymphadenectomy in women with tumors >20 mm. FDG-PET/CT seems redundant for nodal staging in women with early-stage cervical cancer.

https://doi.org/10.1136/ijgc-2021-IGCS.18

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