Sentinel node in gynaecological oncology

Abstract

Background

The concept of sentinel node biopsy has been widely invastigated in various malignant tumoures and has become a standard method in such neoplastic diseases as penile cancer or melanoma. In tumours, where the lymphatic flow is more complicated and difficult to analyze, this concept still needs to be verified.

Aim

The aim of this paper is to present the validity of the above concept in sentinel node detection in vulvar, cervical and endometrial cancers.

Materials/Methods

Sentinel node detection was performed in 127 women with gynaecological malignances; 39 patients with vulvar cancer, 52 patients with cervical cancer and 36 patients with endometrial cancer. In sentinel node detection we used radioisotopes and a dye technique. After sentinel node dissection, in all cases, radical surgery with systemic lymphadenectomy was performed. The number and localization of the nodes classified as sentinel nodes were analyzed.

Results

The identification rate for sentinel node detection was 97.4% in vulvar cancer, 96.2% in cervical cancer and 88.9% in endometrial cancer. The sensitivity in this procedures was 100.0% in vulvar cancer, 94.0% in cervical cancer and 87.9% in endometrial cancer.

Negative predictive value was 96.2% for vulvar cancer, 97.0% for cervical cancer and 100.0% for endometrial cancer.

Conclusions

The concept of sentinel node detection in gynaecological malignances requires more clinical date for its validation, but outcomes in vulvar cancer seem to be potentially most promising.