[Clinical study of sentinel lymph node detection guided radical abdominal trachelectomy]

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Nuclear Medicine Imaging

Context:

• Early-stage cervical squamous cell carcinoma presents a challenge for surgical management, balancing oncologic control with preservation of reproductive function.
• Sentinel lymph node (SLN) biopsy is an evolving technique to accurately stage nodal involvement.
• Radical abdominal trachelectomy (RAT) is a fertility-sparing surgical option for select patients.

Purpose:

• To assess the clinical utility of SLN biopsy in predicting pelvic lymph node metastasis in early cervical cancer.
• To evaluate the feasibility and outcomes of guiding RAT based on SLN status.
• To observe post-operative follow-up and fertility outcomes in patients undergoing SLN-guided RAT.

Summary:

• Sentinel lymph nodes (SLNs) were identified in 100% of 31 patients with stage Ia2-Ib1 cervical squamous cell carcinoma using (99m)Tc-labeled phytate.
• SLN analysis demonstrated 100% sensitivity and accuracy in predicting pelvic lymph node status, with no missed micrometastases.
• RAT was performed in node-negative SLN cases, resulting in no relapses and successful pregnancies in 5 of 19 patients desiring fertility.

Impact:

• SLN detection provides reliable prediction of lymph node status, enabling appropriate surgical planning for early cervical cancer.
• SLN-guided RAT is a feasible and effective fertility-sparing surgical approach with favorable oncologic outcomes and low complication rates.
• This approach supports the management of young patients with cervical cancer who wish to preserve their reproductive potential.