TY - JOUR T1 - Pelvic Lymphadenectomy Improves Survival in Patients With Cervical Cancer With Low-Volume Disease in the Sentinel Node: A Retrospective Multicenter Cohort Study JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 303 LP - 311 DO - 10.1097/IGC.0000000000000043 VL - 24 IS - 2 AU - Afra Zaal AU - Ronald P. Zweemer AU - Michal Zikán AU - Ladislav Dusek AU - Denis Querleu AU - Fabrice Lécuru AU - Anne-Sophie Bats AU - Robert Jach AU - Libor Sevcik AU - Petar Graf AU - Jaroslav Klát AU - Grzegorz Dyduch AU - Silvia von Mensdorff-Pouilly AU - Gemma G. Kenter AU - René H.M. Verheijen AU - David Cibula Y1 - 2014/02/01 UR - http://ijgc.bmj.com/content/24/2/303.abstract N2 - Objective In this study, we aimed to describe the value of pelvic lymph node dissection (LND) after sentinel lymph node (SN) biopsy in early-stage cervical cancer.Methods We performed a retrospective multicenter cohort study in 8 gynecological oncology departments. In total, 645 women with International Federation of Gynecology and Obstetrics stage IA to IIB cervical cancer of squamous, adeno, or adenosquamous histologic type who underwent SN biopsy followed by pelvic LND were enrolled in this study. Radioisotope tracers and blue dye were used to localize the sentinel node, and pathologic ultrastaging was performed.Results Among the patients with low-volume disease (micrometastases and isolated tumor cells) in the sentinel node, the overall survival was significantly better (P = 0.046) if more than 16 non-SNs were removed. No such significant difference in survival was detected in patients with negative or macrometastatic sentinel nodes.Conclusions Our findings indicate that in patients with negative or macrometastatic disease in the sentinel nodes, an additional LND did not alter survival. Conversely, our data suggest that the survival of patients with low-volume disease is improved when more than 16 additional lymph nodes are removed. If in a prospective trial our data are confirmed, we would suggest a 2-stage operation. ER -