Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer.
BACKGROUND AND OBJECTIVES
Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis.


METHODS
We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned.


RESULTS
All patients could be evaluated for SLNs; a total of 610 SLNs were analyzed. Although the specificity of both imprint cytology and frozen-section examination was 100.0%, the sensitivity was only 58.6 and 65.5%, respectively. The diagnostic sensitivity was higher in 2-mm slices along the short axis than on bisection along the longitudinal axis. Imprint cytology correctly diagnosed 2 patients who had false-negative results on frozen section. The nature of the metastatic foci that caused an intraoperative false-negative diagnosis was either micrometastasis or isolated tumor cells.


CONCLUSIONS
The accuracy of intraoperative SLN diagnosis requires improvement, especially when small metastatic foci are present.
['Sonoda|Kenzo|K|', 'Yahata|Hideaki|H|', 'Okugawa|Kaoru|K|', 'Kaneki|Eisuke|E|', 'Ohgami|Tatsuhiro|T|', 'Yasunaga|Masafumi|M|', 'Baba|Shingo|S|', 'Oda|Yoshinao|Y|', 'Honda|Hiroshi|H|', 'Kato|Kiyoko|K|']
D000328:Adult D005260:Female D005629:Frozen Sections D006801:Humans D008207:Lymphatic Metastasis D061206:Neoplasm Micrometastasis D009367:Neoplasm Staging D012189:Retrospective Studies D012680:Sensitivity and Specificity D000071036:Sentinel Lymph Node D021701:Sentinel Lymph Node Biopsy D000069339:Trachelectomy D002583:Uterine Cervical Neoplasms D055815:Young Adult
Sentinel lymph node Trachelectomy Neoplasm metastasis Uterine cervical neoplasms