The Sentinel Node Technique Detects Unexpected Drainage Pathways and Allows Nodal Ultrastaging in Early Cervical Cancer:
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ORIGINAL ARTICLE – GYNECOLOGIC ONCOLOGY
The Sentinel Node Technique Detects Unexpected Drainage Pathways and Allows Nodal Ultrastaging in Early Cervical Cancer: Insights from the Multicenter Prospective SENTICOL Study Anne-Sophie Bats, MD, PhD1,2,3 , Patrice Mathevet, MD, PhD4,5, Annie Buenerd, MD6, Isabelle Orliaguet, MD7, Eliane Mery, MD8, Slimane Zerdoud, MD9, Marie-Aude Le Fre`re-Belda, MD, PhD10, Marc Froissart, MD, PhD11, Denis Querleu, MD12, Alejandra Martinez, MD12, Eric Leblanc, MD13, Philippe Morice, MD, PhD14, Emile Daraı¨, MD, PhD15, Henri Marret, MD, PhD16, Florence Gillaizeau, MSc, PhD1,17,18, and Fabrice Le´curu, MD, PhD1,2,3 1
Universite´ Paris Descartes, Sorbonne Paris Cite´, Faculte´ de Me´decine, Paris, France; 2Chirurgie Cance´rologique Gyne´cologique et du Sein, Assistance Publique-Hoˆpitaux de Paris, Hoˆpital Europe´en Georges-Pompidou, Paris, France; 3 INSERM UMR-S 747, Universite´ Paris Descartes, Paris, France; 4Hoˆpital Femme-Me`re-Enfant, Bron, France; 5Universite´ Lyon I, Lyon, France; 6De´partement de Pathologie Est, Groupement Hospitalier Est, Bron, France; 7Me´decine Nucle´aire, Hoˆpital Edouard Herriot, Lyon, France; 8Anatomo-pathologie, Institut Claudius Regaud, Toulouse, France; 9Me´decine Nucle´aire, Institut Claudius Regaud, Toulouse, France; 10Anatomo-pathologie, Assistance Publique-Hoˆpitaux de Paris, Hoˆpital Europe´en Georges-Pompidou, Paris, France; 11Service de Me´decine Nucle´aire, Assistance Publique-Hoˆpitaux de Paris, Hoˆpital Europe´en Georges-Pompidou, Paris, France; 12Chirurgie Ge´ne´rale, Institut Claudius Regaud, Toulouse, France; 13Centre Oscar Lambret, Lille, France; 14Institut Gustave Roussy, Villejuif, France; 15Hoˆpital Tenon, Assistance Publique-Hoˆpitaux de Paris, Paris, France; 16CHRU de Tours, Hoˆpital Bretonneau, Tours, France; 17De´partement d’Informatique Hospitalie`re, Evaluation et Gestion des Connaissances, Assistance Publique-Hoˆpitaux de Paris, Hoˆpital Europe´en Georges-Pompidou, Paris, France; 18INSERM, Centre d’Investigation Epide´miologique 4, Paris, France
ABSTRACT Background. Sentinel lymph node (SLN) biopsy may improve nodal staging in cervical cancer. The aims of this study are to determine the rate of unusual patterns of cervical lymphatic drainage, to determine the rates of micrometastases and isolated tumor cells (ITCs) in SLNs, and to assess the clinical impact of SLN biopsy. Methods. Multicenter prospective study conducted between January 2005 and June 2007 in women undergoing laparoscopic surgery for early cervical cancer. Combined technetium/Patent Blue labeling was used. Lymphoscintigraphy was performed before surgery. SLN location was
Ó Society of Surgical Oncology 2012 First Received: 18 January 2012; Published Online: 22 August 2012 A.-S. Bats, MD, PhD e-mail: [email protected] F. Le´curu, MD, PhD e-mail: [email protected]
recorded, and factors associated with location were explored. SLNs underwent step sectioning ± immunohistochemistry. Results. 145 patients were enrolled and 139 included in a modified int
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