The sentinel lymph node procedure in gynecologic oncology: Review of the literature

Kalogiannidis I, Xiromeritis P, Prapas Y, Prapas N

Department of Gynecologic Oncology and Endoscopy, Iakentro Medical center, Thessaloniki, Greece

Correspondence: Kalogiannidis I, 4 Svolou St, GR-54622, Thessaloniki, Greece. Ε-mail:kalogiannidis@mailbox.gr


Abstract

Lymphadenectomy contributes to the optimal staging and treatment of patients with gynecologic cancer. However, the former approach is not without adverse outcomes. The aim of the sentinel lymph node (SLN) procedure, which is the first node involved by the tumor, is to detect the group of patients with positive SLN, who will benefit from the lymphadenectomy. On the other hand, omitting the lymphadenectomy in case of negative SLN contributes to less surgical morbidity. The high detection rate and negative predictive value, as well as the low percentage of false negative SLN in vulvar cancer, are currently adequate and it seems that in the future the SLN procedure will be part of the clinical practice in the management of early stage (FIGO stage I-II) vulvar cancer. In contrast, due to the high rate of false negative results in patients with cervical cancer, the introduction of SLN in daily practice is problematic. Data for endometrial and ovarian cancer are inadequate. Until more solid evidence from further randomized trials is available, therapy individualization remains the “gold standard” for the implementation of SLN procedure in gynecologic oncology.

Keywords: sentinel lymph node, vulvar cancer, cervical cancer, endometrial cancer, ovarian cancer

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