Utility of Performing Sentinel Lymph Node Biopsy among Women with Early-Stage Cervical Cancer: Literature Review

Objective: Evaluation of the pathological status of the pelvic lymph nodes (LNs) is the most important prognostic factor of recurrence and survival in early -stage cervical cancer. Radical hysterectomy and pelvic lymphadenectomy is the cornerstone treatment of cervical cancer, however the morbidity rate associated with pelvic LN dissection is significantly high. Applying the Sentinel LN (SLN) concept in cervical cancer has been proved to be superior to complete pelvic LN dissection (LND) as it associated with a lower rate of postoperative complications and a higher potential of identification LN metastatses.Aim: The purpose of this paper is to make a review of the literature data regarding the accuracy of using the SLN biopsy (SLNB) in the treatment plan of women with early-stage cervical cancer, and to assess the oncologic safety of omitting complete in all negative SLNB women.Method: We searched Pubmed, Medline, the Cochrane Register , and Embase for English language articles about the diagnostic accuracy ofSLN in detecting lymphatic metastases in cervical cancer using controlled vocabulary (e.g “cervical cancer”) and key words (“ sentinel”, “lymphadenectomy”). Systematic reviews, retrospective studies and clinical non-randomized trials were selected, focusing on the influence of SLNB result on the surgical treatment of early-stage cervical cancer as well as its potential to provide ultra-staging in cervical cancer.Conclusions:The SLN technique for women with cervical cancer decreases the morbidity rate associated with pelvic lymphadenectomy, and has the potential to adequately evaluate the pelvic LN status of these patients. However, there is still concern that LN metastases may be missed if only the SLNs are removed. Despite a negative SLNB, in selected cases of early-stage cervical cancer, pelvic lymphadenectomy is still required.