Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging.

Détails

ID Serval
serval:BIB_299ABAFB4325
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging.
Périodique
Gynecologic oncology
Auteur(s)
Balaya V., Guani B., Benoit L., Magaud L., Bonsang-Kitzis H., Ngô C., Le Frère-Belda M.A., Mathevet P., Lécuru F.
ISSN
1095-6859 (Electronic)
ISSN-L
0090-8258
Statut éditorial
Publié
Date de publication
09/2020
Peer-reviewed
Oui
Volume
158
Numéro
3
Pages
576-583
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
We aimed to assess the diagnostic value of frozen-section pathologic examination (FSE) of sentinel lymph nodes (SLN) in patients with early-stage cervical cancer.
Two French prospective multicentric database on SLN biopsy for cervical cancer (SENTICOL I and II) were analysed. Patients with IA to IIA1 2018 FIGO stage, who underwent SLN biopsy with both FSE and ultrastaging examination were included.
Between 2005 and 2012, 313 patients from 25 centers fulfilled the inclusion criteria. Metastatic involvement of SLN was diagnosed in 52 patients (16.6%). Macrometastases, micrometastases and isolated tumor cells (ITCs) were found in 27, 12 and 13 patients respectively. Among the 928 SLNs analysed, FSE identified 23 SLNs with macrometastases in 20 patients and 5 SLNs with micrometastases in 2 patients whereas no ITCs were identified. Ultrastaging of negative SLNs by FSE found macrometastases, micrometastases and ITCs in additional 7, 11 and 17 SLNs. Ultrastaging increased significantly the rate of patients with positive SLN from 7% to 16.6% (p < 0.0001). The sensitivity and the negative predictive value of FSE were 42.3% and 89.7% respectively or 56.4% and 94.1% if ITCs were excluded. False-negative cases were more frequent with tumor size ≥ 20 mm (OR = 4.46, 95%IC = [1.45-13.66], p = 0.01) and preoperative brachytherapy (OR = 4.47, 95%IC = [1.37-14.63], p = 0.01) and less frequent with patients included in higher volume center (>5 patients/year) (OR = 0.09, 95%IC = [0.02-0.51], p = 0.01).
FSE of SLN had a low sensitivity for detecting micrometastases and ITCs and a high negative predictive value for SLN status. Clinical impact of false-negative cases has to be assessed by further studies.
Mots-clé
Cervical cancer, Frozen section, SENTICOL, Sentinel lymph node, Ultrastaging
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/07/2020 17:32
Dernière modification de la notice
28/05/2021 6:36
Données d'usage