The sentinel lymph node: relevance in gynaecological cancers

Area of Science:

• Oncology
• Surgical Pathology
• Gynecologic Oncology

Background:

• Sentinel lymph node (SLN) detection is a standard procedure for melanoma and breast cancer, guiding regional lymph node management.
• Recent research has expanded the investigation of SLN detection to various solid tumors, including gynecological cancers.

Purpose of the Study:

• To review the current evidence for sentinel lymph node detection in gynecological cancers.
• To assess the potential impact of SLN detection on clinical practice and patient morbidity in this patient population.

Main Methods:

• An extensive literature review was conducted on published reports concerning SLN detection in gynecological cancers.
• Studies were categorized based on the level of evidence provided to evaluate their clinical significance.

Main Results:

• Vulva cancer is the most studied gynecological cancer for SLN detection due to its accessible nodal basin.
• While lacking randomized controlled trials, data suggest SLN detection in vulva cancer may reduce the need for extensive groin lymphadenectomies.
• For other gynecological cancers, lymphatic drainage is less predictable, techniques are not standardized, and evidence supporting SLN applicability is weak.

Conclusions:

• Sentinel lymph node detection in vulva cancer may decrease morbidity by reducing radical groin lymphadenectomies.
• The potential for SLN detection to alter clinical practice in other gynecological cancers is currently limited due to insufficient evidence.