SLN biopsy in cervical cancer patients with tumors larger than 2cm and 4cm.
OBJECTIVES
The aim of this study was to assess the detection rate, false-negative rate and sensitivity of SLN in LN staging in tumors over 2cm on a large cohort of patients.


METHODS
Data from patients with stages pT1a - pT2 cervical cancer who underwent surgical treatment, including SLN biopsy followed by systematic pelvic lymphadenectomy, were retrospectively analyzed. A combined technique with blue dye and radiocolloid was modified in larger tumors to inject the tracer into the residual cervical stroma.


RESULTS
The study included 350 patients with stages pT1a - pT2. Macrometastases, micrometastases, and isolated tumor cells were found in 10%, 8%, and 4% of cases. Bilateral detection rate was similar in subgroups with tumors<2cm, 2-3.9cm, and ≥4cm (79%, 83%, 76%) (P=0.460). There were only two cases with false-negative SLN ultrastaging for pelvic LN status among those with bilateral SLN detection. The false negative rate was very low in all three subgroups of different tumor sizes (0.9%, 0.9%, and 0.0%; P=0.999). Sensitivity reached 96% in the whole group and was high in all three groups (93%, 93%, 100%; P=0.510).


CONCLUSIONS
If the tracer application technique is adjusted in larger tumors, SLN biopsy can be equally reliable in pelvic LN staging in tumors smaller and larger than 2cm. The bilateral detection rate and false negative rate did not differ in subgroups of patients with tumors<2cm, 2-3.9cm, and ≥4cm.
['Dostálek|L|L|', 'Zikan|M|M|', 'Fischerova|D|D|', 'Kocian|R|R|', 'Germanova|A|A|', 'Frühauf|F|F|', 'Dusek|L|L|', 'Slama|J|J|', 'Dundr|P|P|', 'Nemejcova|K|K|', 'Cibula|D|D|']
D000230:Adenocarcinoma D000328:Adult D000368:Aged D018196:Carcinoma, Adenosquamous D002294:Carcinoma, Squamous Cell D005188:False Negative Reactions D005260:Female D006801:Humans D008197:Lymph Node Excision D008198:Lymph Nodes D008207:Lymphatic Metastasis D008875:Middle Aged D061206:Neoplasm Micrometastasis D009367:Neoplasm Staging D010388:Pelvis D012680:Sensitivity and Specificity D021701:Sentinel Lymph Node Biopsy D047368:Tumor Burden D002583:Uterine Cervical Neoplasms
Cervical cancer Detection rate Sensitivity False negative rate Bulky Sentinel lymph node