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Risk factors for failure of bilateral sentinel lymph node mapping in early-stage cervical cancer

2019; Elsevier BV; Volume: 156; Issue: 1 Linguagem: Inglês

10.1016/j.ygyno.2019.10.027

1095-6859

Vincent Balaya, Arnaud Bresset, Benedetta Guani, Laurent Magaud, Rosa Montero-Macías, Myriam Deloménie, Hélène Bonsang‐Kitzis, Charlotte Ngô, Anne‐Sophie Bats, Patrice Mathevet, Fabrice Lécuru,

Cervical Cancer and HPV Research

Background The objective of this study was to determine clinical, tumoral and surgical factors associated with successful bilateral sentinel lymph node mapping (SBM) in early-stage cervical cancer. Methods We performed an ancillary work on the data of two prospective trials on SLN biopsy for FIGO IA-IIA cervical cancer (SENTICOL I & II). Patients having Sentinel lymph node (SLN) mapping for early-stage cervical cancer were included between 2005 and 2012 from 28 French oncologic centers. SLN was detected by a combined labeling technique (blue and isotopic). Results 405 patients were included for analysis: SLNs were identified on at least one side of the pelvis in 381 patients (94.1%) and bilaterally in 326 patients (80.5%). The mean age was 45.4 years [22–85 years]. Most patients had IB1 pathologic FIGO 2018 stage (81.3%) and squamous cell carcinoma (71%). Surgeries were mainly performed by minimally invasive approach (368 patients – 90.9%). By multivariate analysis, lower SBM rate was significantly associated with Age ≥70 years (ORa = 0.02, 95%CI = [0.001–0.28], p = 0.004), tumor size larger than 20 mm (ORa = 0.46,95%CI = [0.21–0.99], p = 0.048) and Body-mass index higher than 30 kg/m2 (ORa = 0.28, 95%CI = [0.12–0.65], p = 0.003). SBM rate was significantly higher in high skills centers (>5patients/year) (ORa = 8.05, 95%CI = [2.06–31.50], p = 0.003) and in SENTICOL II (2009–2012) compared to SENTICOL I (2005–2007) (ORa = 2.6, 95%CI = [1.23–5.51], p = 0.01). Conclusions In early-stage cervical cancer, bilateral SLN detection rates is lower in patients aged more than 70years, patients with BMI≥30 kg/m2 and larger tumor ≥20 mm whereas stronger experience of SLN biopsy technique improves bilateral SLN detection.