Long-term follow up after sentinel node biopsy alone for early-stage cervical cancer

Yahata, Hideaki; Kodama, Kazuhisa; Okugawa, Kaoru; Hachisuga, Kazuhisa; Yasutake, Nobuko; Maenohara, Shoji; Yagi, Hiroshi; Yasunaga, Masafumi; Ohgami, Tatsuhiro; Onoyama, Ichiro; Asanoma, Kazuo; Kobayashi, Hiroaki; Sonoda, Kenzo; Baba, Shingo; Ishigami, Kousei; Ohishi, Yoshihiro; Oda, Yoshinao; Kato, Kanefusa

doi:10.1016/j.ygyno.2022.01.031

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…In addition to increasing operative time and blood loss, PLND can also cause postoperative complications such as lymphedema and lymphangitis that may decrease quality of life. 12,13 Such complications can be avoided by omitting PLND for cases without lymph node metastasis that are diagnosed intraoperatively by SLNB. 13 Dye, radioisotope (RI), and fluorescent tracers are currently used to monitor SLN.…”

Section: Introductionmentioning

confidence: 99%

“…12,13 Such complications can be avoided by omitting PLND for cases without lymph node metastasis that are diagnosed intraoperatively by SLNB. 13 Dye, radioisotope (RI), and fluorescent tracers are currently used to monitor SLN. 14 Technetium-99m (99mTc)-labeled phytic acid used with RI methods has a high molecular weight and is retained for long periods in the first node of lymphatic flow from a tumor, thus making this method suitable for SLNB.…”

Section: Introductionmentioning

confidence: 99%

“…However, since the rate of lymph node metastasis in early‐stage cervical cancer is approximately 10%–20%, 9–11 many patients may be receiving unnecessary PLND. In addition to increasing operative time and blood loss, PLND can also cause postoperative complications such as lymphedema and lymphangitis that may decrease quality of life 12,13 . Such complications can be avoided by omitting PLND for cases without lymph node metastasis that are diagnosed intraoperatively by SLNB 13 …”

Section: Introductionmentioning

confidence: 99%

“…Technetium‐99m (99mTc)‐labeled phytic acid used with RI methods has a high molecular weight and is retained for long periods in the first node of lymphatic flow from a tumor, thus making this method suitable for SLNB. In fact, we have reported a high detection rate for SLN metastases in cervical cancer patients using the 99mTc‐based RI method alone 13,15,16 . However, RI methods require specialized equipment and expertise, which limits their availability.…”

Section: Introductionmentioning

confidence: 99%

“… 12 , 13 Such complications can be avoided by omitting PLND for cases without lymph node metastasis that are diagnosed intraoperatively by SLNB. 13 …”

Section: Introductionmentioning

confidence: 99%

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Development of novel tracers for sentinel node identification in cervical cancer

Kodama,

Tateishi,

Oda

et al. 2023

Cancer Science

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Indocyanine green (ICG) with near‐infrared (NIR) fluorescence imaging is used for lymphatic mapping. However, binding of ICG to blood proteins like serum albumin can shorten its retention time in sentinel lymph nodes (SLNs). Here, we investigated the efficacy and safety of a new fluorescence tracer comprising phytate and liposome (LP)‐encapsulated ICG. Coadministration of phytate with LP containing phosphatidic acid promotes chelation mediated by Ca2+ in bodily fluids to enhance SLN retention. Uniformly sized LPs (100 nm) encapsulating ICG under conditions that minimized fluorescence self‐quenching during storage were produced. We analyzed the behavior of the new tracer (ICG‐phytate‐LP) and control tracers (ICG and ICG‐LP) in the lymphatic flow of mice in terms of lymph node retention time. We also tested lymphatic flow and safety in pigs that have a more human‐like lymphatic system. LPs encapsulating stabilized ICG were successfully prepared. Mixing LP with phytate in the presence of Ca2+ increased both the particle size and negative surface charge. In mice, ICG‐phytate‐LP had the best lymph node retention, with a fluorescence intensity ratio that increased over 6 h and then decreased slowly over the next 24 h. In pigs, administration of ICG and ICG‐phytate‐LP resulted in no death or weight loss. There were no obvious differences between blood test results for the ICG and ICG‐phytate‐LP groups, and the overall safety was good. ICG‐phytate‐LP may be a useful new tracer for gynecological cancers that require time for lymph node identification due to a retroperitoneal approach.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 12 , 13 Such complications can be avoided by omitting PLND for cases without lymph node metastasis that are diagnosed intraoperatively by SLNB. 13 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Development of novel tracers for sentinel node identification in cervical cancer

Kodama,

Tateishi,

Oda

et al. 2023

Cancer Science

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Sentinel Navigation Surgery for Local Advanced Cervical Cancer

Terai

2024

Comprehensive Gynecology and Obstetrics

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Long-term outcomes of sentinel lymph node navigation surgery for early-stage cervical cancer

Togami,

Furuzono,

Mizuno

et al. 2024

Int J Clin Oncol

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Background Sentinel lymph node navigation surgery, which identifies the sentinel lymph node in early cervical cancers and omits systemic pelvic lymphadenectomy in cases where no lymph node metastasis is present, has recently gained attention. However, there are few reports on lymph node recurrence and the long-term outcomes of cervical cancer surgery performed using sentinel lymph node navigation surgery. In this study, we aimed to evaluate the long-term outcomes of sentinel node navigation surgery for early-stage cervical cancer. Methods One hundred thirty-eight patients with cervical cancer were enrolled. Sentinel lymph nodes were identified by injecting 99 m Technetium-labeled phytate and indocyanine green into the uterine cervix. Surgery and survival outcomes were also analyzed. Results The median age and body mass index of the patients were 40 years (20–78) and 21.7 kg/m2 (16.5–50.4), respectively. Open surgery, laparoscopic surgery, and robotic surgery were performed in 77 (56%), 53 (38%), and 8 (6%) patients, respectively. The overall and bilateral detection rates of the sentinel lymph node were 100% and 94%, respectively. Only one case (0.7%) exhibited lower extremity lymphedema, and pelvic lymphocele was observed in three cases (2.2%). Four cases (3%) experienced recurrence over a median follow-up of 57.5 months (range, 2–115 months), with five-year recurrence-free and overall survival rates of 97% and 97.3%, respectively. Conclusions Our results demonstrate that sentinel node navigation surgery may be safe and effective for early-stage cervical cancer.

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Long-term follow up after sentinel node biopsy alone for early-stage cervical cancer

Cited by 9 publications

References 20 publications

Development of novel tracers for sentinel node identification in cervical cancer

Development of novel tracers for sentinel node identification in cervical cancer

Sentinel Navigation Surgery for Local Advanced Cervical Cancer

Long-term outcomes of sentinel lymph node navigation surgery for early-stage cervical cancer

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