Efficacy of Sentinel Lymph Node Sampling for Early Cervical Cancer: A Single Institute Study

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Sentinel lymph node (SLN) biopsy is a crucial technique in managing early-stage cervical cancer.
• Radioisotope (RI) tracers were approved for gynecological cancers in Japan in 2023, expanding SLN biopsy applications.
• Our institution has utilized SLN biopsy for cervical cancer since 2009, accumulating extensive experience.

Purpose of the Study:

• To evaluate the efficacy and safety of SLN biopsy in early-stage cervical cancer patients.
• To compare oncologic outcomes and complication rates between SLN biopsy and traditional pelvic lymph node dissection (PLND).
• To assess the impact of SLN biopsy on patient quality of life.

Main Methods:

• A retrospective study of 136 patients with FIGO 2008 stage IA1-IB1 cervical cancer from January 2009 to December 2023.
• SLNs were identified using a combination of radioisotope (RI) and patent blue dye.
• Patients were divided into a PLND group (n=50) and a sentinel node navigation surgery (SNNS) group (n=86).

Main Results:

• The SLN detection rate was 84% with 100% sensitivity for metastasis in the PLND group.
• Lymphedema incidence was significantly lower in the SNNS group (5.8%) compared to the PLND group (20.0%).
• Five-year progression-free survival (88.6% vs 92.2%) and overall survival (95.5% vs 97.8%) showed no significant differences between groups.

Conclusions:

• SLN biopsy is an effective and safe oncologic procedure for early-stage cervical cancer.
• The technique enhances patient quality of life by reducing lymphedema incidence.
• SLN biopsy allows for comparable oncologic outcomes to traditional PLND while minimizing morbidity.