Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan.
Int J Clin Oncol. 2024 Nov;29(11):1740-1745. doi: 10.1007/s10147-024-02605-0. Epub 2024 Sep 2.
Sentinel lymph node navigation surgery, which identifies the sentinel lymph node in early cervical cancers and omits systemic pelvic lymphadenectomy in cases where no lymph node metastasis is present, has recently gained attention. However, there are few reports on lymph node recurrence and the long-term outcomes of cervical cancer surgery performed using sentinel lymph node navigation surgery. In this study, we aimed to evaluate the long-term outcomes of sentinel node navigation surgery for early-stage cervical cancer.
One hundred thirty-eight patients with cervical cancer were enrolled. Sentinel lymph nodes were identified by injecting 99 m Technetium-labeled phytate and indocyanine green into the uterine cervix. Surgery and survival outcomes were also analyzed.
The median age and body mass index of the patients were 40 years (20-78) and 21.7 kg/m (16.5-50.4), respectively. Open surgery, laparoscopic surgery, and robotic surgery were performed in 77 (56%), 53 (38%), and 8 (6%) patients, respectively. The overall and bilateral detection rates of the sentinel lymph node were 100% and 94%, respectively. Only one case (0.7%) exhibited lower extremity lymphedema, and pelvic lymphocele was observed in three cases (2.2%). Four cases (3%) experienced recurrence over a median follow-up of 57.5 months (range, 2-115 months), with five-year recurrence-free and overall survival rates of 97% and 97.3%, respectively.
Our results demonstrate that sentinel node navigation surgery may be safe and effective for early-stage cervical cancer.
前哨淋巴结导航手术通过在早期宫颈癌中识别前哨淋巴结,并在未发现淋巴结转移的情况下省略系统的盆腔淋巴结清扫术,最近引起了关注。然而,关于使用前哨淋巴结导航手术治疗宫颈癌的淋巴结复发和长期结果的报道较少。本研究旨在评估前哨淋巴结导航手术治疗早期宫颈癌的长期结果。
共纳入 138 例宫颈癌患者。通过将 99m 锝标记植酸钠和吲哚菁绿注入子宫颈来识别前哨淋巴结。还分析了手术和生存结果。
患者的中位年龄和体重指数分别为 40 岁(20-78)和 21.7kg/m(16.5-50.4)。分别有 77 例(56%)、53 例(38%)和 8 例(6%)患者接受了开放手术、腹腔镜手术和机器人手术。前哨淋巴结的整体和双侧检测率分别为 100%和 94%。仅 1 例(0.7%)出现下肢淋巴水肿,3 例(2.2%)出现盆腔淋巴囊肿。中位随访 57.5 个月(范围 2-115 个月)后,4 例(3%)出现复发,5 年无复发生存率和总生存率分别为 97%和 97.3%。
我们的结果表明,前哨淋巴结导航手术可能对早期宫颈癌安全有效。