Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study.

Détails

ID Serval
serval:BIB_B475AB1CC05B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Feasibility and performance of lymphoscintigraphy in sentinel lymph node biopsy for early cervical cancer: results of the prospective multicenter SENTICOL study.
Périodique
Annals of Nuclear Medicine
Auteur(s)
Bats A.S., Frati A., Froissart M., Orliaguet I., Querleu D., Zerdoud S., Leblanc E., Gauthier H., Uzan C., Deandreis D., Darai E., Kerrou K., Marret H., Lenain E., Mathevet P., Lecuru F.
ISSN
1864-6433 (Electronic)
ISSN-L
0914-7187
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
29
Numéro
1
Pages
63-70
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVE: To evaluate feasibility, SLN detection rate, and SLN location of lymphoscintigraphy in sentinel lymph node (SLN) biopsy for early cervical cancer.
METHODS: Ancillary analysis of data from the multicenter prospective SENTICOL study (January 2005-June 2007) of patients with early cervical cancer (FIGO stage IA with emboli to IB1) was conducted. Preoperative lymphoscintigraphy was performed after intracervical administration of 60 or 120 MBq of (99m)Tc-labeled radiocolloid on the day before (long protocol) or morning of (short protocol) surgery. SLNs were identified intraoperatively using combined radioactivity/patent blue detection. SLNs were sampled electively and routine bilateral pelvic lymphadenectomy was performed by laparoscopy. A centralized review of lymphoscintigraphies was performed to assess feasibility, detection rates, and anatomic SLN location.
RESULTS: Of 139 patients included in the SENTICOL study, 133 received radiocolloid injection, and 131 (98.5 %) underwent preoperative lymphoscintigraphy, with the long protocol in three-fourths of cases. The lymphoscintigraphic detection rate was 87.8 %, with a median of 2 (1-4) SLNs per patient. By multivariate analysis, factors independently associated with lymphoscintigraphic SLN detection were age [odds ratio (OR) 0.91, 95 % confidence interval (95 % CI) 0.87-0.96; P < 0.001], and protocol (long vs. short; OR 8.23, 95 % CI 1.87-36.25; P = 0.005). Bilateral SLN identification by lymphoscintigraphy occurred in 67 % of cases and was independently influenced by age (OR 0.95, 95 % CI 0.92-0.98, P < 0.001) and protocol (OR 5.42, 95 % CI 2.21-13.27; P < 0.001). Although 60.5 % of preoperative SLNs were in the external iliac territory, unusual drainage patterns included the common iliac (19.6 %), para-aortic (10.8 %), and parametrial (6 %) basins.
CONCLUSIONS: Our study demonstrates the feasibility and good detection rate of preoperative lymphoscintigraphy, with better detection in younger patients and with the long protocol. The high proportion of SLN basins in unexpected territories is of interest to guide intraoperative detection. Further studies are needed to better evaluate preoperative detection and to assess the contribution of lymphoscintigraphy to intraoperative detection.
Mots-clé
Adult, Age Factors, Feasibility Studies, Female, Humans, Lymphoscintigraphy/methods, Prospective Studies, Sentinel Lymph Node Biopsy/methods, Uterine Cervical Neoplasms/pathology, Uterine Cervical Neoplasms/radionuclide imaging
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/02/2015 9:39
Dernière modification de la notice
09/05/2019 0:04
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