TY - JOUR
T1 - Survival after sentinel node biopsy alone in early-stage cervical cancer
T2 - A systematic review
AU - Mauro, Jessica
AU - Viveros-Carreño, David
AU - Vizzielli, Giuseppe
AU - De Ponti, Elena
AU - Fanfani, Francesco
AU - Ramirez, Pedro T.
AU - Buda, Alessandro
N1 - © IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/9/4
Y1 - 2023/9/4
N2 - 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.
AB - 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.
KW - cervical cancer
KW - sentinel lymph node
KW - SLN and lympadenectomy
KW - Lymph Node Excision
KW - Sentinel Lymph Node Biopsy/methods
KW - Humans
KW - Lymphatic Metastasis/pathology
KW - Sentinel Lymph Node/surgery
KW - Uterine Cervical Neoplasms/surgery
KW - Lymph Nodes/pathology
KW - Female
KW - Retrospective Studies
KW - Neoplasm Staging
UR - http://www.scopus.com/inward/record.url?scp=85168955366&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85168955366&partnerID=8YFLogxK
U2 - 10.1136/ijgc-2023-004692
DO - 10.1136/ijgc-2023-004692
M3 - Article
C2 - 37586759
AN - SCOPUS:85168955366
SN - 1048-891X
VL - 33
SP - 1370
EP - 1375
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
IS - 9
ER -