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Updated: Nov 19, 2025
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Pathological factors associated with non-sentinel lymph node metastasis in early stage cervical cancer
Thiago P Diniz1, Carlos C Faloppa1, Henrique Mantoan1
1Department of Gynecologic Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil.
Objective:
To analyze the predictive factors for non-sentinel lymph node (non-SLN) metastasis in early-stage cervical cancer.
Methods:
We analyzed a series of 113 patients who underwent sentinel lymph node (SLN) mapping for cervical cancer. The SLNs were examined by immunohistochemistry (IHC) when the hematoxylin-eosin stain was negative.
Results:
The overall bilateral detection rate was 81.5%, with a median of two SLNs resected. The study ultimately included 92 patients with SLNs that were mapped who had also undergone systematic pelvic lymph node dissection. Thirteen (14.1%) patients had positive SLNs, with a median of one positive SLN. Regarding the size of SLN metastasis, one (1.1%) had isolated tumor cells (ITC), seven (7.6%) had micrometastases, and five (5.4%) had macrometastases. Notably, 46.1% (6/13) had lymph node metastases detected only after IHC. Five (38.5%) cases had positive non-SLNs, with a median count of one positive lymph node. Parametrial invasion was the only risk factor for positive non-SLN (p = .045). Regarding the size of SLN metastasis, non-SLN involvement was present in the only case with ITC (1/1), 42.9% (3/7) of cases with micrometastases, and in 20% (1/5) with macrometastases.
Conclusions:
Our data suggest that parametrial invasion correlates with the risk of non-SLN metastasis in cervical cancer.
