Sentinel Lymph Node Staging in Early-Stage Cervical Cancer: A Comprehensive Review.
Chrysoula Margioula-SiarkouAristarchos AlmperisGiuseppe GulloEmmanouela-Aliki AlmperiGeorgia Margioula-SiarkouEleni NixarlidouKonstantina MponiouPavlos PapakotoulasChrisanthi SardeliFrederic GuyonKonstantinos DinasStamatios PetousisPublished in: Journal of clinical medicine (2023)
Cervical cancer (CC) continues to be a significant global public health concern, even with preventive measures in place. In women with early-stage CC, the status of lymph nodes is of paramount importance, not only for the final prognosis but also for determining the best therapeutic strategy. According to main international guidelines, pelvic full lymphadenectomy (PLND) is recommended for lymph node staging. However, in these early stages of CC, sentinel lymph node biopsy (SLNB) has emerged as a precise technique for evaluating lymph node involvement, improving its morbidity profile. We performed a literature review through PubMed articles about progress on the application of SLNB in women with early-stage CC focusing on the comparison with PET/CT and PLND in terms of oncological outcomes and diagnostic accuracy. While the superiority of SLNB is clear compared to radiologic modalities, it demonstrates no clear oncologic inferiority over PLND, given the higher detection rate of positive lymph nodes and predominance of no lymph node recurrences. However, due to a lack of prospective evidence, particularly concerning long-term oncological safety, SLNB is not the current gold standard. With careful patient selection and adherence to straightforward protocols, a low false-negative rate can be ensured. The aim of the ongoing prospective trials is to address these issues.
Keyphrases
- lymph node
- sentinel lymph node
- early stage
- pet ct
- rectal cancer
- public health
- neoadjuvant chemotherapy
- radical prostatectomy
- case report
- robot assisted
- prostate cancer
- locally advanced
- positron emission tomography
- metabolic syndrome
- squamous cell carcinoma
- adipose tissue
- clinical practice
- glycemic control
- skeletal muscle
- radiation therapy
- global health
- insulin resistance
- type diabetes
- minimally invasive
- silver nanoparticles
- lymph node metastasis
- sensitive detection