John Libbey Eurotext

Bulletin du Cancer


Sentinel lymph node biopsy in cervical and endometrial cancers: a feasibility study Volume 91, issue 4, Avril 2004

Service de chirurgie gynécologique et oncologique Service d’anatomie pathologique Département de physiologie et radio‐isotopes Hôpital européen Georges‐Pompidou, Assistance Publique‐Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris

The sentinel lymph node (SLN) biopsy has been proposed for the cancers of the uterus in order to optimize the diagnosis of lymphatic metastases and micrometastases in early stage tumors. Patients with early invasive cervical (n ∓ 8) or endometrial (n ∓ 15) cancers were enrolled. A lymphoscintigraphy was carried out before the intervention. Intraoperative SLN identification was performed with blue dye combined to a handheld gamma probe detection. Non‐sentinel pelvic nodes were separately cleared out. SLNs were examined with frozen sections, permanent sections with hematoxylin‐eosin staining and further serial sections with immunohistochemistry if negative. Six cervical cancer patients and 13 endometrial cancer patients had a positive lymphoscintigraphy, showing in 5 patients extra‐iliac SLN(s). The intraoperative detection was successful in 6 cervical cancer patients and 14 endometrial cancer patients. The higher detection rate was obtained with the isotopic method. Most of the SLNs were ilio‐obturator. Four endometrial cancer patients had a lymphatic spread, only involving the SLN in each case. No false negative SLN has been noted. SLN biopsy appears feasible in cervical and endometrial cancers. This procedure could improve the lymphatic evaluation of these cancers. ▴