SLN mapping in early-stage cervical cancer as a minimal-invasive triaging tool for multimodal treatment.

Papadia, Andrea; Morosi, Chiara; Wang, Junjie; Gasparri, Marialuigia; Rau, Tilman; Ghezzi, Fabio; Mueller, Michael D. (2019). SLN mapping in early-stage cervical cancer as a minimal-invasive triaging tool for multimodal treatment. European journal of surgical oncology EJSO, 45(4), pp. 679-683. Elsevier 10.1016/j.ejso.2019.01.184

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BACKGROUND To evaluate sensitivity, false negative rate and negative predictive value of the combination of sentinel lymph node (SLN) mapping and frozen section (FS) in triaging cervical cancer patients to a definitive chemo-radiotherapy. METHODS A retrospective analysis of patients with histologically proven cervical cancer undergoing laparoscopic SLN mapping and frozen section of the SLNs followed by a completion radical hysterectomy, pelvic and/or paraarotic lymphadenectomy. Sensitivity, false negative rate and negative predictive value of the SLN mapping, of the frozen section and of the combination of the two in identifying micro- and macrometastases were calculated. RESULTS One-hundred and four patients with cervical cancer underwent surgery. Of these, 87 (83.7%) had bilateral detection rates at the SLN mapping and underwent FS evaluation and were selected for statistical analysis. Twenty-five patients had lymph nodal metastases at H&E staining. Of these, 24 displayed metastatic disease to the SLNs and one to a NSLN accounting for a FN rate of 4.0%. Metastases were identified in 21 patients at the FS analysis. Four patients had metastases in the SLNs that were missed at the FS analysis. The FN rate of the FS is 12.5% if we excluded isolated tumour cells in the analysis. The FN rate of the combined methodology (SLN mapping and FS of the SLN) is 16%. Twenty-one out of 25 patients (84.0%) could correctly be triaged to a definitive chemo-radiotherapy. CONCLUSIONS The combination of SLN mapping and FS of the SLNs is efficient in triaging patients to a definitive chemo-radiotherapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Papadia, Andrea; Rau, Tilman and Mueller, Michael

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0748-7983

Publisher:

Elsevier

Language:

English

Submitter:

Monika Zehr

Date Deposited:

27 Dec 2019 07:45

Last Modified:

07 Jan 2020 07:11

Publisher DOI:

10.1016/j.ejso.2019.01.184

PubMed ID:

30732972

Uncontrolled Keywords:

Cervical cancer Chemo-radiotherapy Frozen section analysis Indocyanine green Laparoscopy Sentinel lymph node mapping

BORIS DOI:

10.7892/boris.136490

URI:

https://boris.unibe.ch/id/eprint/136490

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