SLNB Flashcards

1
Q

When is SLNB most effective?

A

For tumours less than 2cm in size.

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2
Q

What is the benefit of identification of positive nodes pre-operatively?

A

Would identify the selection of women that would benefit from primary chemo-radiotherapy and can spare these women the additional morbidity associated with rad hyst and pelvic lymphadenectomy.

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3
Q

What is the NPV of an uninvolved sentinel node?

A

95%

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4
Q

What is the most reliable method for detection of SLN?

What bilateral detection rates can you achieve?

A

Combined use of Technetium-99m colloid (99mTc) lymphoscintigraphy and blue dye currently appears
to be the most reliable detection method for SLNB.

92-97% when used together

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5
Q

What is a newer alternative for SLN detection?

A

Near infrared fluorescence imaging (NIR) with the use of indocyanine green (ICG)

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6
Q

What are the contraindications for ICG

A

iodine hypersensitivity
Renal failure
pregnancy
breast feeding

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7
Q

What happens if you are unable to locate a SLN on one side?

A

They require a full lymphadenectomy in that hemi-pelvis

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8
Q

How should SLNB be processed?

A

SLNs should be processed by serial sectioning and immunohistochemistry. Multiple studies
have found that intra-operative frozen section is limited in its ability to identify small metastases and
micro-metastatic disease

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9
Q

How should SLNB be used clinically

A

First they have the SLNB - then await histology (as intra-op not sensitive in normal sized LN). Then definitive surgery at a later date if negative.

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10
Q

If a unit does SLNB - what should the women be told?

A

The women should be advised that the long-term survival outcomes following SLNB alone are not available.

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11
Q

What trial and when shall we expect five year SLNB alone in negative SLN results?

A

SENTIX study

end of 2021

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12
Q

Can we use SLNB in the management of women with cervical cancer?

A

it can be considered for tumours less than 2cm in diameter in addition to formal PLND

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13
Q

What happens if you see a large or suspicious LN at the time of SLN mapping?

A

must be removed

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14
Q

What should we include on the specimen request form?

A

cervical screening history

results of previous biopsies

dimensions of the cancer, radiology results and details of all specimens sent.

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