Clinical study of sentinel lymph node biopsy in early uterine cervical carcinoma.

BACKGROUND Radical hysterectomy and complete pelvic lymphadenectomy is the standard treatment for early cervical carcinoma. But the rate of pelvic and paraaortic nodal metastasis is found to be low, pointing that most of the patients possibly undergo unnecessary nodal dissection. AIM To study the value of sentinel lymph nodes (SLNs) in prediction of the pelvic lymph node status and to determine the significance of SLN detection in pelvic lymph node dissection in patients with early stage cervical carcinoma. SETTINGS AND DESIGN Retrospective study. METHODS From August 2002 to August 2004, 20 patients with early stage cervical carcinoma, planned to undergo radical hysterectomy and extensive pelvic lymph node dissection received an intracervical injection of a blue dye to identify and perform resection of SLN. The SLNs were pathologically compared with non-SLNs with frozen section, paraffin section, and anti-cytokeratin immunohistochemical staining. RESULTS Out of 20 patients, SLNs were detected in 15 patients. A total of 46 SLNs were identified and the mean was 3 per patient. The detection rate of SLN was 75%. Sensitivity, specificity and accuracy of the SLN biopsy were 75%, 100% and 95%, respectively. CONCLUSION SLN detection can predict the pelvic lymph node status in early stage cervical carcinoma, but the feasibility and safety of this technique to substitute conventional surgical modality should be evaluated by large series of prospective studies.