Worldwide, cervical cancer is the fourth most common malignancy among women. Radical hysterectomy and pelvic lymphadenectomy is the standard treatment for early stage cervical cancer. If lymph node metastasis is present at the time of diagnosis, 5-year survival rate drops from 90% to 57%. The risk of lymph node metastases in women with early stage cervical cancer is approximately 15%, and determines the use of adjuvant treatment. Over 80% of patients do not benefit from pelvic lymphadenectomy, but may suffer from adverse complications or sequelae such as lymphedema, lymphocyst formation, and neurovascular and ureteral injury. The sentinel lymph node is the first node to which metastatic disease will spread from a primary tumor. The clinical benefits of biopsy of only the sentinel lymph node includes a significant reduction in the adverse effects of complete lymphadenectomy. The specific benefits of sentinel lymph node detection in early stage cervical cancer includes improved identification of metastatic lymph nodes through ultrastaging and identification of alternate lymph node drainage sites, as well as the possibility of intraoperative frozen section analysis, which may be used to guide surgical management. Sentinel lymph node detection in early stage cervical cancer could become the standard of care in the near future.
Part of the book: Gynecologic Cancers