Izvorni znanstveni članak

https://doi.org/10.20471/acc.2025.64.03.01

Sentinel Lymph Node Biopsy in Locally Advanced Cervical Cancer: A Prospective, Single-Center Study

Pavao Planinić ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Goran Vujić ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Ivan Babić ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Velena Radošević ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Luka Matak ; Department of Obstetrics and Gynecology, Zadar General Hospital, Zadar, Croatia
Mislav Mikuš ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia *
Joško Lešin ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Ante Ćorušić† ; Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia

* Dopisni autor.

Sažetak

Cervical cancer is one of the most common malignant tumors of the female reproductive
system in women aged 15-35 years. Sentinel lymph node (SLN) biopsy is a diagnostic procedure
used to determine status of local or regional lymph nodes of the tumor. In this article, we report the main
results of our prospective study designed to assess diagnostic accuracy of SLN biopsy in women with
early-stage cervical cancer using our modified tracer application technique. A total of 49 women with an
early stage cervical carcinoma (FIGO stage IA2-IIA1) underwent a SLN procedure at the Zagreb University
Hospital Center, Zagreb, Croatia. Radical abdominal hysterectomy with bilateral pelvic lymph
node dissection was performed in all study women. We performed SLN biopsy with diluted methylene
blue injected submucosally prior to surgery at 4 quadrants of the cervix and at 4 quadrants at the level of
the cervix transition to vaginal vaults. The application was successfully performed in all women. In total,
46 women with FIGO staging IA2 (19.57%), IB1 (71.73%), IB2 (6.53%), IIA1 (2.17%) were enrolled
in the study. A total of 1338 lymph nodes were removed, and 254 of these were SLNs with the mean
value of 2.76 per pelvic side. Of these 254 SLNs, there were 13 positive SLNs in 7 women, whereas 241
non-SLNs were observed. Detection rate according to the number of participants and number of pelvic
sides with at least one SLN detected on each side was 100%. In total, 92 pelvis sides were analyzed and
at least one SLN was found on each side. Thus, bilateral SLN detection rate was 100%. Lymph node
metastases were detected on 9 (9.8%) pelvic sides and false-negative rate was 1.09%. The sensitivity and
negative predictive values were 88.9% and 98.9%, respectively. There were no differences in detection
rate according to patient age, tumor size and FIGO stage. Interiliac and obturator fossa was the most
common localization of SLN in 84.4% of cases. To the best of our knowledge, this is the first prospective
study presenting a new modified tracer application technique in the SLN biopsy procedure. We present
a novel, simple and feasible technique with well established points of application and volumes of tracer,
demonstrating high overall and bilateral detection rates even in tumors >2 cm. Special emphasis should
be on using this technique with indocyanine green application.

Ključne riječi

Cervical cancer; Sentinel lymph node; Radical abdominal hysterectomy

Hrčak ID:

342572

URI

https://hrcak.srce.hr/342572

Datum izdavanja:

30.9.2025.

Podaci na drugim jezicima: hrvatski

Posjeta: 491 *