RESUMEN
UNLABELLED: The purpose of this study was to examine the clinical usefulness of preoperative lymphoscintigraphy (PLS) for sentinel node identification in patients undergoing lymphatic mapping during surgery for early cervical cancer. PATIENTS AND METHODS: Day-before PLS was performed in 42 patients who were candidates for open radical hysterectomy and intraoperative lymphatic mapping, using a combination of radiocolloid and blue dye technique. RESULTS: In 39 patients, at least one sentinel node (SN) was evident either in the lymphoscintigram or during the operation (detection rate 92.8%). Lymphoscintigraphy revealed unilateral SNs in 24 (61.5%) cases and bilateral SNs in 15 (38.5%). A total of 56 SNs were identified. Intraoperatively, 5 out of 24 patients with unilateral SNs on PLS had bilateral identification. The total number of SNs retrieved was 103 (2.6/patient). While one SN was identified in 25 cases on PLS, 32 patients had two or more SNs intraoperatively. The agreement between preoperative and intraoperative detection regarding laterality, number and location of SNs was poor (Kappa<0.69). CONCLUSION: PLS is of limited clinical value for intraoperative SN detection in early cervical cancer.
Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Biopsia del Ganglio Linfático Centinela/métodos , Neoplasias del Cuello Uterino/diagnóstico por imagen , Neoplasias del Cuello Uterino/cirugía , Femenino , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática , Estadificación de Neoplasias , Cintigrafía/métodos , Agregado de Albúmina Marcado con Tecnecio Tc 99m , Neoplasias del Cuello Uterino/patologíaRESUMEN
BACKGROUND: The sentinel lymph node (SLN) technique aims at predicting the absence of regional nodal metastasis and seems promising in the management of cervical cancer patients. PATIENTS AND METHODS: Forty patients undergoing surgery for early cervical cancer were submitted to the SLN procedure, using Blue Patente alone in 3, radiocolloid injection alone in 4 and both methods in 33 (82.5%). All patients underwent radical hysterectomy and pelvic lymphadenectomy. RESULTS: The detection rate was as follows: overall 85%, blue dye alone 66%, radiocolloid alone 75%, dual method 87%. Detection was successful in 34 patients, with one false-negative result. No micrometastases were demonstrated during ultrastaging of the sentinels. The detection rate was higher in tumors <2 cm (94.1%) than in larger tumors (78.2%, p>0.09). Significant negative correlation between lymphatic vascular space invasion (LVSI) and detection rate was found (p<0.001). CONCLUSION: SLN detection is feasible in early cervical cancer but presence of LVSI and a tumor size >2 cm negatively affect the detection rate and may increase the incidence of false negatives.
Asunto(s)
Vasos Linfáticos/patología , Invasividad Neoplásica , Biopsia del Ganglio Linfático Centinela , Neoplasias del Cuello Uterino/patología , Femenino , HumanosRESUMEN
OBJECTIVES: To evaluate the accuracy of visual examination of myometrial invasion and the involvement of the cervix in the hysterectomy specimen and to explore the role of tumor grade and size in the accuracy of gross estimation of myometrial invasion. METHODS: In 142 patients with apparent early endometrial cancer the uterus was opened after its removal and inspected. The size of the tumor (Asunto(s)
Neoplasias Endometriales/patología
, Miometrio/patología
, Neoplasias del Cuello Uterino/patología
, Adulto
, Anciano
, Anciano de 80 o más Años
, Neoplasias Endometriales/cirugía
, Femenino
, Humanos
, Periodo Intraoperatorio/métodos
, Persona de Mediana Edad
, Invasividad Neoplásica
, Estadificación de Neoplasias
, Sensibilidad y Especificidad