Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.
Curr Opin Oncol. 2024 Sep 1;36(5):406-411. doi: 10.1097/CCO.0000000000001059. Epub 2024 Jun 17.
The most common surgical procedure associated with lymphedema formation is the regional lymphadenectomy. One of the advantages of sentinel node biopsy is the reduction of the risk of lymphedema formation. The purpose of this review is to collect and analyze the most relevant and recent evidence of the use of sentinel node biopsy and its implication on the development of postoperative lymphedema in gynecological cancer.
The current evidence of the use of sentinel node biopsy in cervical cancer to reduce lymphedema is heterogeneous and more data is needed to establish its role.Sentinel lymph node biopsy in endometrial cancer is a staging procedure with lower surgical complications, as well as lymphedema formation; while the results of prospective trials evaluating its impact on quality of life are still lacking.Sentinel lymph node biopsy in vulvar cancer minimizes the need for extensive dissection and reduces the incidence of complications associated with overharvesting of lymph nodes such as lymphedema without compromising oncological outcomes.
The prevalence of lymphedema in gynecological cancer varies based on the surgical treatment or additional therapies applied. Over the past years, one of the most important surgical modifications to decrease lymphedema formation has been implementation of sentinel lymph node technique mainly in vulvar cancer patients.
与淋巴水肿形成最相关的手术是区域淋巴结清扫术。前哨淋巴结活检的一个优点是降低了淋巴水肿形成的风险。本综述的目的是收集和分析使用前哨淋巴结活检术及其对妇科癌症术后淋巴水肿发展的影响的最新证据。
目前关于前哨淋巴结活检术在宫颈癌中减少淋巴水肿的证据是异质的，需要更多的数据来确定其作用。前哨淋巴结活检术在子宫内膜癌中是一种分期手术，手术并发症较少，淋巴水肿形成也较少；然而，评估其对生活质量影响的前瞻性试验结果仍缺乏。前哨淋巴结活检术在外阴癌中最大限度地减少了广泛解剖的需要，并减少了与过度采集淋巴结相关的并发症（如淋巴水肿）的发生率，而不影响肿瘤学结果。
妇科癌症患者淋巴水肿的发生率取决于所应用的手术治疗或其他治疗方法。在过去几年中，减少淋巴水肿形成的最重要的手术改良之一是实施前哨淋巴结技术，主要应用于外阴癌患者。
