Article Text
Abstract
Introduction/Background Multiple studies have shown the accuracy and feasibility of sentinel lymph node (SLN) biopsy in early-stage disease. However, there is no prospective evidence on long-term oncological safety yet. We report the results from our center comparing the SLN alone with SLN and PLD.
Methodology Women who underwent radical surgery for cervical cancer with a FIGO stage IA1-IIB from May 2001 to September 2021 at Hospital Clínic in Barcelona (Spain) were enrolled.
From 2001 to 2011, the SLN procedure was being validated by our group; therefore, patients underwent systematic PLD after SLN dissection (PLD group). From 2012 to 2021, only SLN with intraoperative evaluation was performed. All patients underwent radical hysterectomy or trachelectomy. Adjuvant radiotherapy was considered in the presence of combination of risk factors.
Results 171 patients were enrolled: 86 in PLD group and 85 in SNL group. At least one SLN was detected in 166 women (97% overall detection rate). Bilateral SLN detection was successful in 58% and 96,5% in PDL and SLN group, respectively. The sensitivity of the SLN technique to identify intraoperative nodal metastatic disease was 33.3% and overall nodal metastatic was 100%. The negative predictive value of the technique was 100%.
Ultrastaging with immunohistochemistry detected low-volume metastatic disease in SLNs in 4 cases (1.8%): one case of ITCs and three cases with micrometastases.
Progression free survival rates at two- and five-year were 94% and 91.6%, and 97.6% and 94.4% in the PLD and SLN group, respectively, while the OS rates were 98.8% and 96.3%, and 98.7% and 98.7% in the PDL and SLN group, respectively. There was no significant difference in the Kaplan-Meier PFS and OS curves between the two groups.
Conclusion SLN does not seem to be associated with a worse long-term oncological outcome compared to PLD for patients with early-stage cervical cancer in this serie.
Disclosures No conflicts of interest.