Survival after sentinel node biopsy alone in early-stage cervical cancer: A systematic review

Jessica Mauro, David Viveros-Carreño, Giuseppe Vizzielli, Elena De Ponti, Francesco Fanfani, Pedro T. Ramirez, Alessandro Buda

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To assess the oncologic outcomes of sentinel lymph node biopsy alone as part of surgical management in patients with early-stage cervical cancer. Methods A systematic search of the literature was performed following the PRISMA checklist. MEDLINE (through PubMed), EMBASE, and Scopus databases were searched from June 1991 to May 2023. Studies of women with early-stage cervical cancer International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IIA, of any age or histology, and articles only in English language were included. After the removal of duplicates, only articles including sentinel node mapping alone compared with full pelvic lymphadenectomy were retained. Results Four studies with a total of 2226 patients were included. Among these, 354 (15.9%) underwent sentinel lymph node biopsy alone. A total of 2210 (99.2%) patients had FIGO 2009 stage I disease and 1514 (68%) patients had squamous cell carcinoma. Median body mass index was 25.5 kg/m 2 (range 23.5-27). Lymph vascular space invasion was present in 633 patients (34%) who underwent full lymphadenectomy and in 78 patients (22%) who underwent sentinel node biopsy alone. The results of the survival analysis showed that there was no significant difference in the 3-year progression-free survival rates of patients who underwent either sentinel biopsy alone or lymphadenectomy. Three-year recurrence-free survival was 93.1% (95% CI 28.3% to 64.7%) for patients who underwent sentinel node biopsy alone and 92.5% (95% CI 39.0% to 53.4%) for patients who underwent sentinel node biopsy and lymphadenectomy (p=0.773). Conclusions In patients with early-stage cervical cancer, performing sentinel lymph node biopsy alone compared with pelvic lymphadenectomy does not appear to independently confer a higher risk or recurrence.

Original languageEnglish (US)
Pages (from-to)1370-1375
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume33
Issue number9
DOIs
StatePublished - Sep 4 2023

Keywords

  • cervical cancer
  • sentinel lymph node
  • SLN and lympadenectomy
  • Lymph Node Excision
  • Sentinel Lymph Node Biopsy/methods
  • Humans
  • Lymphatic Metastasis/pathology
  • Sentinel Lymph Node/surgery
  • Uterine Cervical Neoplasms/surgery
  • Lymph Nodes/pathology
  • Female
  • Retrospective Studies
  • Neoplasm Staging

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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