Early Stage Flashcards
Discuss use of sentinel lymph nodes in early cervical cancer
Senticol - Lecuru JCO 2011
IA1 with LVSI to IB1 - got Tc99 ans blue followed by LSC mapping followed by LND
139 patients included in modified intention to diagnose analysis
92% sensitivity
98.2% NPV
No false negative results when SLN identified bilaterally, 2 false negatives overall
Senticol 2
IA2 to IIA1SLN alone or SLN and pelvic LND followed by rad hyst or trachelectomy
206 randomized, no false negatives in followed by PLND group
Early morbidity lower in SLND group and rate of neurologic symptoms, no different in lymphedema between groups over time (differences decreased over time), 3y RFS was not statistically different (92 SLN vs 94%)
Concluded early decreased lymphatic morbidity
Senticol 2 long term follow up
Median follow up 47 months
8% recurrence, 4 nodal recurrence, 3.5% died of cervical czncer
DFS 85 and 80% NS
DSS 90.8 and 97.2 NS
SLND was not associated with DFS or DSS
Only pathologic risk factors according to sedlis were independent predictor of DFS and DSS
Senticol 3
