Update on sentinel lymph node evaluation in gynecologic malignancies

Curr Opin Obstet Gynecol. 2011 Feb;23(1):8-12. doi: 10.1097/gco.0b013e32834156fb.

Abstract

Purpose of review: Sentinel lymph node (SLN) dissections have been shown to be sensitive for the evaluation of nodal basins for metastatic disease and are associated with decreased short-term and long-term morbidity when compared with complete lymph node dissection. There has been increasing interest in the use of SLN technology in gynecologic cancers. This review assesses the current evidence-based literature for the use of SLN dissections in gynecologic malignancies.

Recent findings: Recent literature continues to support the safety and feasibility of SLN biopsy for early stage vulvar cancer with negative predictive value approaching 100% and low false negative rates. Alternatively, for endometrial cancer most studies have reported low false-negative rates, with variable sensitivities and have reported low detection rates of the sentinel node. Studies examining the utility of SLN biopsy in early-stage cervical cancer remain promising with detection rates, sensitivities, and false-negative rates greater than 90% for stage 1B1 tumors.

Summary: SLN dissections have been shown to be effective and safe in certain, select vulvar cancer patients and can be considered an alternative surgical approach for these patients. For endometrial and cervical cancer, SLN dissection continues to have encouraging results and however needs further investigation.

Publication types

  • Evaluation Study
  • Review

MeSH terms

  • Endometrial Neoplasms / pathology*
  • Evidence-Based Medicine
  • False Negative Reactions
  • Feasibility Studies
  • Female
  • Humans
  • Neoplasm Staging
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy* / adverse effects
  • Uterine Cervical Neoplasms / pathology*
  • Vulvar Neoplasms / pathology*