Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer

Beatrice Cormier, John P. Diaz, Karin Shih, Rachael M. Sampson, Yukio Sonoda, Kay J. Park, Khaled Alektiar, Dennis S. Chi, Richard R. Barakat, Nadeem R. Abu-Rustum

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Objective: To establish an algorithm that incorporates sentinel lymph node (SLN) mapping to the surgical treatment of early cervical cancer, ensuring that lymph node (LN) metastases are accurately detected but minimizing the need for complete lymphadenectomy (LND). Methods: A prospectively maintained database of all patients who underwent SLN procedure followed by a complete bilateral pelvic LND for cervical cancer (FIGO stages IA1 with LVI to IIA) from 03/2003 to 09/2010 was analyzed. The surgical algorithm we evaluated included the following: 1. SLNs are removed and submitted to ultrastaging; 2. any suspicious LN is removed regardless of mapping; 3. if only unilateral mapping is noted, a contralateral side-specific pelvic LND is performed (including inter-iliac nodes); and 4. parametrectomy en bloc with primary tumor resection is done in all cases. We retrospectively applied the algorithm to determine how it would have performed. Results: One hundred twenty-two patients were included. Median SLN count was 3 and median total LN count was 20. At least one SLN was identified in 93% of cases (114/122), while optimal (bilateral) mapping was achieved in 75% of cases (91/122). SLN correctly diagnosed 21 of 25 patients with nodal spread. When the algorithm was applied, all patients with LN metastasis were detected; with optimal mapping, bilateral pelvic LND could have been avoided in 75% of cases. Conclusions: In the surgical treatment of early cervical cancer, the algorithm we propose allows for comprehensive detection of all patients with nodal disease and spares complete LND in the majority of cases.

Original languageEnglish
Pages (from-to)275-280
Number of pages6
JournalGynecologic Oncology
Volume122
Issue number2
DOIs
StatePublished - Aug 1 2011

Fingerprint

Uterine Cervical Neoplasms
Lymph Nodes
Neoplasm Metastasis
Therapeutics
Lymph Node Excision
Sentinel Lymph Node
Databases
Neoplasms

Keywords

  • Algorithm
  • Cervical cancer
  • Sentinel lymph node

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Cormier, B., Diaz, J. P., Shih, K., Sampson, R. M., Sonoda, Y., Park, K. J., ... Abu-Rustum, N. R. (2011). Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecologic Oncology, 122(2), 275-280. https://doi.org/10.1016/j.ygyno.2011.04.023

Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. / Cormier, Beatrice; Diaz, John P.; Shih, Karin; Sampson, Rachael M.; Sonoda, Yukio; Park, Kay J.; Alektiar, Khaled; Chi, Dennis S.; Barakat, Richard R.; Abu-Rustum, Nadeem R.

In: Gynecologic Oncology, Vol. 122, No. 2, 01.08.2011, p. 275-280.

Research output: Contribution to journalArticle

Cormier, B, Diaz, JP, Shih, K, Sampson, RM, Sonoda, Y, Park, KJ, Alektiar, K, Chi, DS, Barakat, RR & Abu-Rustum, NR 2011, 'Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer', Gynecologic Oncology, vol. 122, no. 2, pp. 275-280. https://doi.org/10.1016/j.ygyno.2011.04.023
Cormier, Beatrice ; Diaz, John P. ; Shih, Karin ; Sampson, Rachael M. ; Sonoda, Yukio ; Park, Kay J. ; Alektiar, Khaled ; Chi, Dennis S. ; Barakat, Richard R. ; Abu-Rustum, Nadeem R. / Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. In: Gynecologic Oncology. 2011 ; Vol. 122, No. 2. pp. 275-280.
@article{3bd36340914a45fe8dd5d4503d5fae29,
title = "Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer",
abstract = "Objective: To establish an algorithm that incorporates sentinel lymph node (SLN) mapping to the surgical treatment of early cervical cancer, ensuring that lymph node (LN) metastases are accurately detected but minimizing the need for complete lymphadenectomy (LND). Methods: A prospectively maintained database of all patients who underwent SLN procedure followed by a complete bilateral pelvic LND for cervical cancer (FIGO stages IA1 with LVI to IIA) from 03/2003 to 09/2010 was analyzed. The surgical algorithm we evaluated included the following: 1. SLNs are removed and submitted to ultrastaging; 2. any suspicious LN is removed regardless of mapping; 3. if only unilateral mapping is noted, a contralateral side-specific pelvic LND is performed (including inter-iliac nodes); and 4. parametrectomy en bloc with primary tumor resection is done in all cases. We retrospectively applied the algorithm to determine how it would have performed. Results: One hundred twenty-two patients were included. Median SLN count was 3 and median total LN count was 20. At least one SLN was identified in 93{\%} of cases (114/122), while optimal (bilateral) mapping was achieved in 75{\%} of cases (91/122). SLN correctly diagnosed 21 of 25 patients with nodal spread. When the algorithm was applied, all patients with LN metastasis were detected; with optimal mapping, bilateral pelvic LND could have been avoided in 75{\%} of cases. Conclusions: In the surgical treatment of early cervical cancer, the algorithm we propose allows for comprehensive detection of all patients with nodal disease and spares complete LND in the majority of cases.",
keywords = "Algorithm, Cervical cancer, Sentinel lymph node",
author = "Beatrice Cormier and Diaz, {John P.} and Karin Shih and Sampson, {Rachael M.} and Yukio Sonoda and Park, {Kay J.} and Khaled Alektiar and Chi, {Dennis S.} and Barakat, {Richard R.} and Abu-Rustum, {Nadeem R.}",
year = "2011",
month = "8",
day = "1",
doi = "10.1016/j.ygyno.2011.04.023",
language = "English",
volume = "122",
pages = "275--280",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer

AU - Cormier, Beatrice

AU - Diaz, John P.

AU - Shih, Karin

AU - Sampson, Rachael M.

AU - Sonoda, Yukio

AU - Park, Kay J.

AU - Alektiar, Khaled

AU - Chi, Dennis S.

AU - Barakat, Richard R.

AU - Abu-Rustum, Nadeem R.

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Objective: To establish an algorithm that incorporates sentinel lymph node (SLN) mapping to the surgical treatment of early cervical cancer, ensuring that lymph node (LN) metastases are accurately detected but minimizing the need for complete lymphadenectomy (LND). Methods: A prospectively maintained database of all patients who underwent SLN procedure followed by a complete bilateral pelvic LND for cervical cancer (FIGO stages IA1 with LVI to IIA) from 03/2003 to 09/2010 was analyzed. The surgical algorithm we evaluated included the following: 1. SLNs are removed and submitted to ultrastaging; 2. any suspicious LN is removed regardless of mapping; 3. if only unilateral mapping is noted, a contralateral side-specific pelvic LND is performed (including inter-iliac nodes); and 4. parametrectomy en bloc with primary tumor resection is done in all cases. We retrospectively applied the algorithm to determine how it would have performed. Results: One hundred twenty-two patients were included. Median SLN count was 3 and median total LN count was 20. At least one SLN was identified in 93% of cases (114/122), while optimal (bilateral) mapping was achieved in 75% of cases (91/122). SLN correctly diagnosed 21 of 25 patients with nodal spread. When the algorithm was applied, all patients with LN metastasis were detected; with optimal mapping, bilateral pelvic LND could have been avoided in 75% of cases. Conclusions: In the surgical treatment of early cervical cancer, the algorithm we propose allows for comprehensive detection of all patients with nodal disease and spares complete LND in the majority of cases.

AB - Objective: To establish an algorithm that incorporates sentinel lymph node (SLN) mapping to the surgical treatment of early cervical cancer, ensuring that lymph node (LN) metastases are accurately detected but minimizing the need for complete lymphadenectomy (LND). Methods: A prospectively maintained database of all patients who underwent SLN procedure followed by a complete bilateral pelvic LND for cervical cancer (FIGO stages IA1 with LVI to IIA) from 03/2003 to 09/2010 was analyzed. The surgical algorithm we evaluated included the following: 1. SLNs are removed and submitted to ultrastaging; 2. any suspicious LN is removed regardless of mapping; 3. if only unilateral mapping is noted, a contralateral side-specific pelvic LND is performed (including inter-iliac nodes); and 4. parametrectomy en bloc with primary tumor resection is done in all cases. We retrospectively applied the algorithm to determine how it would have performed. Results: One hundred twenty-two patients were included. Median SLN count was 3 and median total LN count was 20. At least one SLN was identified in 93% of cases (114/122), while optimal (bilateral) mapping was achieved in 75% of cases (91/122). SLN correctly diagnosed 21 of 25 patients with nodal spread. When the algorithm was applied, all patients with LN metastasis were detected; with optimal mapping, bilateral pelvic LND could have been avoided in 75% of cases. Conclusions: In the surgical treatment of early cervical cancer, the algorithm we propose allows for comprehensive detection of all patients with nodal disease and spares complete LND in the majority of cases.

KW - Algorithm

KW - Cervical cancer

KW - Sentinel lymph node

UR - http://www.scopus.com/inward/record.url?scp=79960449671&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960449671&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2011.04.023

DO - 10.1016/j.ygyno.2011.04.023

M3 - Article

VL - 122

SP - 275

EP - 280

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 2

ER -