Sentinel node navigation surgery in cervical and endometrial cancer: a review

Pelvic lymphadenectomy is generally performed to treat early-stage cervical cancer, and pelvic ± para-aortic lymphadenectomy is performed in patients with endometrial cancer confined to the uterus. However, systematic lymphadenectomy is frequently associated with sequelae including lymphocele, lymphedema and cellulitis. The sentinel lymph node concept has been recently applied in the management of patients with gynecological cancer, with the goal of avoiding systematic lymphadenectomy and its associated postoperative complications. In this review, we examine and summarize the recently expanding body of literature and discuss sentinel lymph node navigation during surgery in patients with cervical and endometrial cancer. Current data suggest that sentinel node navigation surgery (SNNS) appears to be feasible for detecting lymph node metastasis compared with systematic lymphadenectomy in patients with early-stage cervical or endometrial cancer. The non-inferiority of long-term prognosis through omission of systematic lymphadenectomy has not been proven by randomized trial, but SNNS decreases lymphatic complications related to systematic lymphadenectomy. Further studies are needed to clarify the necessity of additional systematic lymphadenectomy and/or adjuvant therapy in cases with isolated tumor cells or micrometastasis in SLNs.