Sentinel lymph node (SLN) concept in cervical cancer: Current limitations and unanswered questions

Gynecol Oncol. 2019 Jan;152(1):202-207. doi: 10.1016/j.ygyno.2018.10.007. Epub 2018 Oct 11.

Abstract

Sentinel lymph node (SLN) biopsy has been increasingly used in the management of early-stages cervical cancer instead of systematic pelvic lymph node dissection (PLND). The aim of this article is to give a critical overview of key aspects related to this concept, such as a necessity for reliable detection of micrometastases (MIC) in SLN and the requirements for SLN pathologic ultrastaging, low accuracy of intraoperative detection of SLN involvement, and still a limited evidence of oncological safety of the replacement of PLND by SLN biopsy only in ≥IB1 tumours due to unknown risk of MIC in non-SLN pelvic lymph nodes in patients with negative SLN, and absence of any prospective evidence.

Keywords: Cervical cancer; Low volume disease; Pathologic evaluation; Sentinel lymph node; Ultrastaging.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Female
  • Humans
  • Lymph Node Excision
  • Neoplasm Micrometastasis
  • Prognosis
  • Sentinel Lymph Node / pathology*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery