Efficacy of Sentinel Lymph Node Sampling for Early Cervical Cancer: A Single Institute Study

AIM: Radioisotope (RI) tracers were approved for use in gynecological cancers in Japan in 2023, and their application in sentinel lymph node (SLN) biopsy for cervical cancer is expected to expand. Our institution has been performing SLN biopsies for cervical cancer since 2009. This study aimed to evaluate the efficacy and safety of SLN biopsy in patients with early-stage cervical cancer. METHODS: This study included 136 patients with FIGO 2008 stage IA1 to IB1 cervical cancer who underwent hysterectomy with SLN mapping between January 2009 and December 2023. The SLNs were identified using a combination of RI and dye (patent blue) methods. Systematic pelvic lymph node dissection (PLND) was performed during the initial introduction period. Patients were divided into two groups: the PLND group (n = 50), who underwent systematic dissection until August 2012, and the sentinel node navigation surgery (SNNS) group (n = 86), who underwent SLN biopsy with systematic dissection only when SLN metastasis was detected. Recurrence, prognosis, and complications were compared between the groups. RESULTS: In the PLND group, the SLN detection rate was 84%, and the sensitivity for detecting lymph node metastasis was 100%. Lymphedema occurred in 5.8% and 20.0% of patients in the SNNS and PLND groups, respectively. The 5-year progression-free survival rates in the SNNS and PLND groups were 88.6% and 92.2% respectively. The 5-year overall survival rates were 95.5% and 97.8%, respectively, with no significant differences observed. CONCLUSION: SLN biopsy can improve the quality of life without compromising oncologic outcomes in early-stage cervical cancer.