Stephanie Chow1, Amer Karam. 1. Division of Gynecologic Oncology, Stanford Women's Cancer Center, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford 94305, California, USA.
Abstract
PURPOSE OF REVIEW: To provide an overview of the current knowledge and recent advances of sentinel lymph node (SLN) assessment in uterine, cervical, vulvar, and ovarian cancers. RECENT FINDINGS: In endometrial cancer, SLN evaluation has become increasingly utilized as part of the treatment of early-stage disease, with data showing improved detection of pelvic lymph node metastasis. In cervical cancer, SLN biopsy has also gained increasing traction with studies demonstrating the feasibility and accuracy of SLN detection. Evaluation with frozen section, however, remains limited in the detection of metastases. The prognostic significance of positive SLN in vulvar cancer is currently being investigated, with preliminary data showing lower recurrence rates in patients receiving adjuvant radiation. SUMMARY: SLN evaluation remains standard of care to detect lymph node metastasis in early-staged endometrial cancer. In cervical cancer, SLN biopsy has been shown to be reliable, while decreasing morbidity without impacting disease-free survival in select patients. The technique and high sensitivity of SLN biopsy in vulvar cancer has been demonstrated in large prospective trials. There are no randomized controlled trials in ovarian cancer that evaluate the role of SLN biopsy on treatment and outcome; current SLN evaluation remains investigational.
PURPOSE OF REVIEW: To provide an overview of the current knowledge and recent advances of sentinel lymph node (SLN) assessment in uterine, cervical, vulvar, and ovarian cancers. RECENT FINDINGS: In endometrial cancer, SLN evaluation has become increasingly utilized as part of the treatment of early-stage disease, with data showing improved detection of pelvic lymph node metastasis. In cervical cancer, SLN biopsy has also gained increasing traction with studies demonstrating the feasibility and accuracy of SLN detection. Evaluation with frozen section, however, remains limited in the detection of metastases. The prognostic significance of positive SLN in vulvar cancer is currently being investigated, with preliminary data showing lower recurrence rates in patients receiving adjuvant radiation. SUMMARY: SLN evaluation remains standard of care to detect lymph node metastasis in early-staged endometrial cancer. In cervical cancer, SLN biopsy has been shown to be reliable, while decreasing morbidity without impacting disease-free survival in select patients. The technique and high sensitivity of SLN biopsy in vulvar cancer has been demonstrated in large prospective trials. There are no randomized controlled trials in ovarian cancer that evaluate the role of SLN biopsy on treatment and outcome; current SLN evaluation remains investigational.
Authors: Pei Li; Xuewen He; Yang Li; Jacky Wing Yip Lam; Ryan Tsz Kin Kwok; Cun Chuan Wang; Li Gang Xia; Ben Zhong Tang Journal: Eur J Nucl Med Mol Imaging Date: 2022-03-12 Impact factor: 10.057
Authors: Ravali A Reddy; Ashley S Moon; Stephanie Chow; Lucas Heilbroner; Brooke Howitt; Elisabeth Diver; Oliver Dorigo; Babak Litkouhi; Malte Renz; Amer Karam Journal: Gynecol Oncol Rep Date: 2022-07-30