CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2020; 80(12): 1212-1220
DOI: 10.1055/a-1128-0168
GebFra Science
Review/Übersicht

Status of Sentinel Lymph Node Biopsy in Vulvar and Cervical Cancer

Article in several languages: English | deutsch
Julia Waldschmidt
Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
,
Lisa Jung
Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
,
Ingolf Juhasz-Böss
Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
› Author Affiliations

Abstract

Assessment of lymphatic metastasis is an essential component of solid tumour staging. Sentinel lymph node (SLN) biopsy is a minimally invasive procedure that allows regional lymph node involvement by tumour to be estimated by selectively examining the sentinel lymph node while minimising the morbidity of systematic lymph node dissection. Within the group of genital cancers, the diagnostic value of SLN biopsy is rated differently. For selected patients with early-stage vulvar cancer (unifocal primary tumour < 4 cm, clinically negative inguinal lymph nodes) the SLN technique is already an established procedure in the guidelines of the German Society for Gynaecology and Obstetrics (DGGG)/German Cancer Society (DKG) and the recommendations of the European Society of Gynaecological Oncology (ESGO). For cervical cancer, SLN biopsy has not yet been sufficiently standardised but can be considered for patients without risk factors with a primary tumour size < 2 cm. The SLN is identified by combined use of radioactive 99mtechnetium nanocolloid and patent blue. The use of indocyanine green offers an alternative for SLN identification with few side effects. Recent studies aim to increase the diagnostic reliability of intraoperative frozen section analysis as this continues to show limited sensitivity in both vulvar and cervical cancer. The rate of detection of micrometastases can be increased by additional ultrastaging, the prognostic significance of which for both diseases is still unclear. The prognostic value of SLN biopsy compared with systematic lymph node dissection is being investigated in current studies (GROINSS-V-II for vulvar cancer and SENTIX-, SENTICOL-3 for cervical cancer). For this review article, a guideline-based literature search was performed in the National Library of Medicine (PubMed/MEDLINE) database with a particular focus on recent cohort studies and conference contributions.



Publication History

Received: 27 July 2020

Accepted after revision: 26 October 2020

Publication Date:
03 December 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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