open access

Vol 92, No 8 (2021)
Research paper
Published online: 2021-04-08
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Factors limiting the detection of sentinel lymph nodes in early-stage cervical cancer

Marcin Sniadecki1, Gina Minarji1, Szymon Wojtylak2, Ewa Wycinka3, Marcin Liro1, Jerzy Iskrzycki4, Dariusz Wydra1
DOI: 10.5603/GP.a2021.0031
·
Pubmed: 33844253
·
Ginekol Pol 2021;92(8):556-562.
Affiliations
  1. Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdansk, Poland
  2. Department of Pathology, Medical University of Gdansk, Poland
  3. Department of Statistics, Faculty of Management, University of Gdansk, Sopot, Poland
  4. Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Poland

open access

Vol 92, No 8 (2021)
ORIGINAL PAPERS Gynecology
Published online: 2021-04-08

Abstract

Objectives: Sentinel lymph node detection (SLND) has not yet displaced lymphadenectomy, but it is a desired supplementary technique in cervical cancer surgery. The aim of our study was to identify the sources of SLND failure while performing the procedure by injecting blue dye (BD) into the cervix in cases of early-stage cervical cancer (ECC).
Material and methods: We analyzed 27 consecutive ECC patients (FIGO IA2–IB1) who underwent hysterectomy with SLND and systematic lymphadenectomy between October 2011 and June 2014. The main inclusion criterion was at least unilateral SLND by BD. Predictors of either unilateral or bilateral staining were identified using multinomial logit models and a decision tree.
Results: Overall, bilateral staining was achieved in nine patients (33%). Among the factors analyzed, BMI > 23.5 kg/m2 was the only factor negatively affecting the quality of SLND using BD (p < 0.02) in the univariable multinomial logit model. All patients with BMI < 23.5 kg/m2 and depth of invasion ≥ 15 mm had unilateral mapping.
Conclusions: Both obese and overweight patients are unlikely to achieve optimal SLN staining with BD alone. Although some possible reasons are discussed, we believe that further studies are needed to clarify the specific limitations of other dyes currently in use.

Abstract

Objectives: Sentinel lymph node detection (SLND) has not yet displaced lymphadenectomy, but it is a desired supplementary technique in cervical cancer surgery. The aim of our study was to identify the sources of SLND failure while performing the procedure by injecting blue dye (BD) into the cervix in cases of early-stage cervical cancer (ECC).
Material and methods: We analyzed 27 consecutive ECC patients (FIGO IA2–IB1) who underwent hysterectomy with SLND and systematic lymphadenectomy between October 2011 and June 2014. The main inclusion criterion was at least unilateral SLND by BD. Predictors of either unilateral or bilateral staining were identified using multinomial logit models and a decision tree.
Results: Overall, bilateral staining was achieved in nine patients (33%). Among the factors analyzed, BMI > 23.5 kg/m2 was the only factor negatively affecting the quality of SLND using BD (p < 0.02) in the univariable multinomial logit model. All patients with BMI < 23.5 kg/m2 and depth of invasion ≥ 15 mm had unilateral mapping.
Conclusions: Both obese and overweight patients are unlikely to achieve optimal SLN staining with BD alone. Although some possible reasons are discussed, we believe that further studies are needed to clarify the specific limitations of other dyes currently in use.

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Keywords

sentinel lymph node; cervical cancer; mapping techniques; gynaecological oncology; blue dye; limitations

About this article
Title

Factors limiting the detection of sentinel lymph nodes in early-stage cervical cancer

Journal

Ginekologia Polska

Issue

Vol 92, No 8 (2021)

Article type

Research paper

Pages

556-562

Published online

2021-04-08

DOI

10.5603/GP.a2021.0031

Pubmed

33844253

Bibliographic record

Ginekol Pol 2021;92(8):556-562.

Keywords

sentinel lymph node
cervical cancer
mapping techniques
gynaecological oncology
blue dye
limitations

Authors

Marcin Sniadecki
Gina Minarji
Szymon Wojtylak
Ewa Wycinka
Marcin Liro
Jerzy Iskrzycki
Dariusz Wydra

References (20)
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