Change in clinical management of sentinel lymph node location in early stage cervical cancer

Díaz-Feijoó, Berta; Pérez-Benavente, María A.; Cabrera, Sílvia; Gil‐Moreno, Antonio; Roca, Isabel; Franco-Camps, Sílvia; Fernández, Mónica Sabaté; García-Jiménez, Ángel; Xercavins, Jordi; Martínez-Palones, José M.

doi:10.1016/j.ygyno.2010.12.336

Cited by 46 publications

(25 citation statements)

References 30 publications

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“…25 SPECT/CT has higher detection rate as compared to planar imaging and anatomical correlation helps surgeons to find sentinel nodes more efficiently intra-operatively. 39,46,67,112,113 Hoogendam et al reported that SPECT/CT decreased the sentinel node retrieval time in cervical cancer patients undergoing robotic assisted surgery. 114 Due to its clinical impact it seems that, if possible, pre-operative SPECT/CT should be integrated in sentinel node mapping of cervical cancer patients.…”

Section: Sentinel Node Location and Impact Of Pre-operative Lymphoscimentioning

confidence: 99%

Sentinel node biopsy for lymph nodal staging of uterine cervix cancer: A systematic review and meta-analysis of the pertinent literature

Kadkhodayan

Hasanzadeh

Treglia

et al. 2015

European Journal of Surgical Oncology (EJSO)

123

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Section: Sentinel Node Location and Impact Of Pre-operative Lymphoscimentioning

confidence: 99%

Sentinel node biopsy for lymph nodal staging of uterine cervix cancer: A systematic review and meta-analysis of the pertinent literature

Kadkhodayan

Hasanzadeh

Treglia

et al. 2015

European Journal of Surgical Oncology (EJSO)

123

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“…One article (25) was discarded because of an overlap in patients with an included study (8). The references cited in the remaining 8 articles were cross-checked and did not yield any additional eligible studies (3)(4)(5)8,9,(26)(27)(28).…”

Section: Literature Search and Assessmentmentioning

confidence: 99%

“…Except for a single International Federation of Gynecology and Obstetrics (FIGO) Stage IIIA case from Klapdor et al (5), all these subjects had early-stage disease (FIGO stage I/II). Lymph node involvement for cervical cancer was reported in all studies except that of Kraft and Havel (8) and ranged from 0.0% to 28.6% (overall mean, 19.8%) (3)(4)(5)9,(26)(27)(28). The outlier of 0% lymph node metastasis occurred in a single study with 10 patients (26).…”

Section: Sln Detectionmentioning

confidence: 99%

“…Five studies could be pooled on the number of SLNs detected by both modalities (3,4,9,26,28). On SPECT/CT, 345 SLNs were visualized in 110 patients, relative to 299 SLNs in 111 patients on lymphoscintigraphy.…”

Section: Sln Detectionmentioning

confidence: 99%

“…A second advantage of this tracer is that preoperative lymphatic mapping by either SPECT/ CT or planar lymphoscintigraphy becomes possible, enabling prediction of the surgical detectability and number of SLNs in an individual patient. This ability aids the surgeon in performing a more direct SLN resection with less disruption of the lymphatic architecture when compared with a full retroperitoneal exploration (3)(4)(5).…”

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confidence: 99%

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^99mTc SPECT/CT Versus Planar Lymphoscintigraphy for Preoperative Sentinel Lymph Node Detection in Cervical Cancer: A Systematic Review and Metaanalysis

et al. 2015

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We aimed to compare SPECT/CT and lymphoscintigraphy on overall and bilateral sentinel lymph node (SLN) detection in cervical cancer patients. Methods: A systematic search was performed on August 1, 2014, in PubMed, Embase, Scopus, and the Cochrane library. The syntax was based on synonyms of the terms cervical cancer, SPECT/CT, and lymphoscintigraphy. Retrieved articles were screened on their title/abstract and considered eligible when an SLN procedure was performed using both imaging modalities and if detection results were reported. Two independent reviewers assessed all included studies on methodologic quality using QUADAS-2. Studies were pooled on their odds ratios (ORs) with a randomeffects model. Results: The search yielded 962 unique articles, of which 8 were ultimately included. The studies were recent retrospective or prospective cohort studies of limited size (n 5 7-51) but sufficient methodologic quality. The median overall detection ($1 SLN in a patient) was 98.6% for SPECT/CT (range, 92.2%-100.0%) and 85.3% for lymphoscintigraphy (range, 70.0%-100.0%). This corresponded to a pooled overall SLN detection OR of 2.5 (95% CI, 1.2-5.3) in favor of SPECT/CT. The reported median bilateral detection ($1 SLN in each hemipelvis) was 69.0% for SPECT/CT (range, 62.7%-79.3%) and 66.7% for lymphoscintigraphy (range, 56.9%-75.8%), yielding a pooled OR of 1.2 (95% CI, 0.7-2.1). No significant difference in the number of visualized SLNs was observed at a pooled ratio of 1.2 (95% CI, 0.9-1.6). In recent years, the sentinel lymph node (SLN) procedure has been increasingly adopted in the staging of cervical cancer patients eligible for surgery. The SLN procedure allows for individualized treatment decisions by accurately ascertaining the lymph node status before radical surgery takes place (1), with the possibility of excluding fertility-sparing surgery or replacing a radical hysterectomy with chemoradiotherapy in patients with tumorpositive lymph nodes.Besides blue dye, the colloid-bound radionuclide 99m Tc is commonly added as a second tracer and has been shown to improve intraoperative SLN detection (2). A second advantage of this tracer is that preoperative lymphatic mapping by either SPECT/ CT or planar lymphoscintigraphy becomes possible, enabling prediction of the surgical detectability and number of SLNs in an individual patient. This ability aids the surgeon in performing a more direct SLN resection with less disruption of the lymphatic architecture when compared with a full retroperitoneal exploration (3-5).Although SPECT/CT is associated with both increased upfront cost and ionizing radiation, it provides a cross-sectional anatomic reference that allows for accurate 3-dimensional SLN localization, which is considered an important advantage over planar lymphoscintigraphy (5-9). Both SPECT/CT and lymphoscintigraphy should ideally have a high SLN detection ability, which largely determines the clinical value of the entire procedure.On the basis of a systematic search of the literature, we compared detection of ...

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Validation of single‐photon emission computed tomography with computed tomography and lymphoscintigraphy for sentinel lymph node identification in cervical cancer

Togami

Tokudome

Fukuda

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo compare single‐photon emission computed tomography with computed tomography (SPECT/CT) and lymphoscintigraphy (LSG) for the detection of sentinel lymph nodes (SLNs) in patients with early‐stage cervical cancer.MethodsThis hospital‐based, single‐center, retrospective study included 128 patients with cervical cancer (aged >18 years) treated between 2014 and 2022. Injection of 99 m Technetium‐labeled phytate into the uterine cervix was used to detect pelvic SLNs. SNL identification rates and locations were analyzed for preoperative LSG and SPECT/CT.ResultsMedian age and body mass index of patients were 40 years (range, 20–78 years) and 21.7 kg/m2 (range, 16–40 kg/m2), respectively. There was no significant difference in overall identification rates (identification of at least one SLN) of SLNs between SPECT/CT (91%) and LSG (88%). There was no significant difference in bilateral SLN identification rates between SPECT/CT (66%) and LSG (65%). A total of 219 pelvic SLNs (110 right and 109 left hemipelvis) were identified by SPECT/CT; the most frequent locations were the obturator (122 SLNs, 56%) and external iliac (67 SLNs, 30%).ConclusionSPECT/CT and LSG showed high SLN identification rates in patients with cervical cancer, and there was no significant difference in overall or bilateral SLN identification rates between the two techniques.

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Change in clinical management of sentinel lymph node location in early stage cervical cancer

Cited by 46 publications

References 30 publications

Sentinel node biopsy for lymph nodal staging of uterine cervix cancer: A systematic review and meta-analysis of the pertinent literature

Sentinel node biopsy for lymph nodal staging of uterine cervix cancer: A systematic review and meta-analysis of the pertinent literature

^99mTc SPECT/CT Versus Planar Lymphoscintigraphy for Preoperative Sentinel Lymph Node Detection in Cervical Cancer: A Systematic Review and Metaanalysis

Validation of single‐photon emission computed tomography with computed tomography and lymphoscintigraphy for sentinel lymph node identification in cervical cancer

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