Sentinel lymph node in cervical cancer: time to move forward.

Details

Serval ID
serval:BIB_A654B97B65C7
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Sentinel lymph node in cervical cancer: time to move forward.
Journal
Chinese clinical oncology
Author(s)
Balaya V., Guani B., Pache B., Durand Y.G., Bonsang-Kitzis H., Ngô C., Mathevet P., Lécuru F.
ISSN
2304-3873 (Electronic)
ISSN-L
2304-3865
Publication state
Published
Issued date
04/2021
Peer-reviewed
Oui
Volume
10
Number
2
Pages
18
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
In early-stage cervical cancer, lymph node status is of paramount importance to determine the best therapeutic strategy and is one of the most important prognostic factors of survival. According to main international guidelines, pelvic full lymphadenectomy is recommended for lymph node staging. Sentinel lymph node (SLN) biopsy is an accurate method for the assessment of lymph nodal involvement and has been suggested instead of systematic pelvic lymph node dissection (PLND). The SLN technique requires a learning-curve to be well performed. Combined detection with technetium-99 and blue dye has been widely used but the recent introduction of indocyanine green (ICG) is of growing interest since it could improve SLN detection. SLN biopsy offers a more accurate anatomical staging by finding potential metastatic nodes outside of usual lymphadenectomy areas. SLN biopsy improves the diagnostic value of lymph node staging with ultrastaging and detection of low-volume nodal metastases [isolated tumor cells (ITCs) and micrometastases]. Appropriate selection of patient and minimal training combined with some simple rules may guarantee a low false negative rate. Several studies have shown that SLN mapping in these patients is feasible, with excellent detection rates and sensitivity. Less-radical lymph node dissection decreases the associated morbidity of PLND, especially the risk of lower-limb lymphoedema, which severely affects patient quality of life. Some points are still subject to debate such as the low accuracy of intraoperative SLN status assessment by frozen section and the impact of micrometastasis on prognosis. Although international guidelines consider SLN biopsy as an alternative to PLND, SLN biopsy alone is not the gold-standard yet due to lack of prospective evidence on long-term oncological safety. The 3 ongoing prospective trials SENTIX, PHENIX and SENTICOL III will most probably give an answer to these issues.
Keywords
Cervical cancer, SENTICOL, lymphatic mapping, sentinel lymph node (SLN), ultrastaging
Pubmed
Web of science
Open Access
Yes
Create date
21/05/2021 17:07
Last modification date
28/05/2021 5:36
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