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Sentinel lymph node mapping in early-stage cervical cancer: Results from the SENTIX prospective multicenter study

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KOCIAN Roman KOHLER Christhardt KLAT Jaroslav JARKOVSKÝ Jiří ZAPARDIEL Ignacio GIAMPAOLO Di Martino LUC van Lonkhuijzen ZIKAN Michal SANCHEZ Octavio Arencibia GIL-IBANEZ Blanca RASPAGLIESIJ Francesco PRESL Jiri MINÁŘ Luboš MAREK Radim KASCAK Peter HAVELKA Pavel MICHAL Martin TOON Van Gorp NEMEJCOVA Kristyna DUNDR Pavel CIBULA David

Rok publikování 2025
Druh Článek v odborném periodiku
Časopis / Zdroj Gynecologic oncology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.sciencedirect.com/science/article/pii/S0090825825010157?pes=vor&utm_source=clarivate&getft_integrator=clarivate
Doi https://doi.org/10.1016/j.ygyno.2025.09.018
Klíčová slova Cervical cancer; Sentinel lymph node biopsy; SLN mapping; Early-stage; Bilateral detection; SENTIX trial
Popis Objective. To assess sentinel lymph node (SLN) bilateral detection rate, anatomical distribution, and tracer performance in early-stage cervical cancer patients undergoing primary surgery, based on data from the prospective multicenter SENTIX trial. Methods. Patients with FIGO 2018 stage IA1 (LVSI+) to IB2 cervical cancer and no suspicious lymph nodes on preoperative imaging were enrolled in the SENTIX trial. SLN biopsy was performed using blue dye (BD), radiocolloid (RC), indocyanine green (ICG), or their combinations. Only patients with successful bilateral SLN detection and negative intraoperative frozen section proceeded to radical hysterectomy or fertility-sparing surgery. SLN locations and metastatic status were documented by anatomical region and centrally reviewed for consistency. Results. Among 724 patients who underwent SLN biopsy, the overall bilateral detection rate was 92.3 %, with the highest rate (100%) achieved using ICG and RC combination. If mapping-failure cases were considered, the bilateral detection rate would be 84.6%. Most SLNs (91.6 %) were located at pelvic level I, predominantly in the external iliac and interiliac regions. SLNs above the interiliac bifurcation were infrequent (2.7 %), and isolated positive SLNs in pelvic level II were rare (1.3 %). No SLNs were identified in paraaortic regions. Bilateral detection was unaffected by BMI, histology, or prior conization. Although detection was slightly lower in tumors >2 cm, bilateral rates exceeded 90 %. Conclusions. SLN mapping demonstrated high bilateral detection across tracers and patient subgroups. Nearly all SLNs were confined to pelvic level I, underscoring anatomical predictability. These results demonstrate reproducible SLN mapping in tumors <= 4 cm and may help inform individualized surgical planning. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar tech

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