TY - JOUR T1 - Management of Pelvic Lymph Nodes by Sentinel Node Navigation Surgery in the Treatment of Invasive Cervical Cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1113 LP - 1118 DO - 10.1111/IGC.0b013e3181a83d65 VL - 19 IS - 6 AU - Tsuyoshi Yamashita AU - Hideto Katayama AU - Yasuhito Kato AU - Kunihiko Nishiwaki AU - Hiroaki Hayashi AU - Naoyuki Miyokawa AU - Kazuo Sengoku Y1 - 2009/07/01 UR - http://ijgc.bmj.com/content/19/6/1113.abstract N2 - Objective: Diagnosis of lymph node metastasis is a critical issue in the treatment of cervical cancer. Many studies describing sentinel node navigation surgery (SNNS) for examination of node status have been reported in the past decade. In this study, the feasibility of node status diagnosis by SNNS, including intraoperative frozen section diagnosis, in patients with early and advanced cervical cancer was evaluated.Patients and Methods: Fifty-eight cervical cancer patients with early and advanced stage disease were enrolled. All patients were treated with backup pelvic lymphadenectomy after SNNS. To detect sentinel lymph nodes (SLNs), radioactive material and/or blue dye were used as tracers. Lymph nodes confirmed as SLNs were immediately sent to pathologists and diagnosed by frozen section intraoperatively.Results: A total of 118 and 16 SLNs were pathologically investigated in early and advanced stage cervical cancer, respectively. The detection rate of SLNs in the early and advanced stages was 94.7% and 66.7%, respectively, whereas the detection rate using 1 or 2 tracers was 62.5% and 90%, respectively. The false-negative rate and negative predictive value was 0% and 100% for all stages. Pathological diagnosis by frozen section was completed within 30 minutes in all cases.Conclusions: Our data demonstrate that SNNS in cervical cancer is a promising procedure for patients with early stage (up to Ib1) disease, especially patients with small tumor diameter (<2.0 cm). However, SNNS raises several points for discussion before it can be established as a practical clinical procedure or as part of a subsequent radical hysterectomy. ER -