Sentinal Lymph Node in Cervical Cancer Reduces Complications

In the uncommon application of Sentinel Lymph Node (SLN) procedure to cervical cancer, Sunnybrook researchers have further validated its application as safe and practical in the treatment of the disease according to a study published in this month’s Gynecologic Oncology.

“SLN procedure is becoming a preferred procedure because of associated reductions in morbidity, and to deliver this procedure successfully has meant even stronger collaboration across pathology, nuclear medicine and surgery teams,” says Dr. Allan Covens, one of only a handful of surgeons worldwide performing this procedure in cervical cancer treatment. Dr. Covens is also lead investigator of the study and a surgical oncologist at Odette Cancer Centre.

Lymph node status is the most important predictive factor in cervical cancer. More often applied in breast cancer, SLN procedure identifies the sentinel lymph nodes which are the first lymph nodes to receive the drainage of cancer cells from the site of a tumour. SLN procedure removes 1 to 2 sentinel lymph nodes compared to the standard full node dissection removal of 10 to 30 lymph nodes, and has been proven to reduce morbidity or complications such as pain, nausea and lymphedema or chronic swelling of a patient’s leg(s) and or soft tissue.

To perform the procedure and reduce the risk of missing malignant lymph nodes or minimizing the false negative rate, the researchers looked at the cervix as a midline structure and evaluated each side of the patient, instead of evaluating the patient unilaterally. The incidence of detecting at least one sentinel node was 98 per cent per patient, and 85 per cent per side.

Cervical cancer first develops in the cells of the cervix or lower part of a woman’s uterus. In 2007, an estimated 1,350 Canadian women will be diagnosed with cervical cancer, and an estimated 390 will not survive the disease.