||Keisuke Kodama, Hideaki Yahata, Masako Kijima, Nobuko Yasutake, Hiroshi Yagi, Masafumi Yasunaga, Tatsuhiro Ohgami, Ichiro Onoyama, Eisuke Kaneki, Kaoru Okugawa, Kazuo Asanoma, and Kiyoko Kato, Long-term follow-up after sentinel node navigation surgery for early-stage cervical cancer, 第72回日本産科婦人科学術講演会, 2020.04, (Objective) To evaluate the long-term prognostic outcome and complications in patients with early-stage cervical cancer after sentinel node navigation surgery (SNNS) for hysterectomy or trachelectomy.
(Methods) We performed SNNS in 133 patients with cervical cancer using a radioisotope method between 2009 and 2015 under informed consent. If the intraoperative sentinel lymph node evaluation was negative for metastasis, no further lymph nodes were removed. This study was approved by the institutional review board.
(Results) The median age of the 133 patients was 33 (range, 21–73) years. The International Federation of Gynecology and Obstetrics stage was IA1 in 4 patients, IA2 in 12, IB1 in 114, and IIA1 in 3. The histological subtype was squamous cell carcinoma in 88 patients, endocervical adenocarcinoma in 34, and adenosquamous carcinoma in 11. The mean number of sentinel lymph nodes detected per patient was 3.2. Among the 133 patients, 8 did not undergo pelvic lymphadenectomy because of a false-negative intraoperative diagnosis, and 19 received adjuvant therapy after surgery (chemotherapy in 16, radiation in 3). Over a median follow-up of 69 (range, 20–127) months, two patients (2%) experienced recurrence after 44 and 100 months, one in the lung as metastasis and one in the pelvic lymph node, respectively. After multidisciplinary therapy, these two patients are alive without disease at the time of writing. Regarding postoperative complications, lymphedema, lymphocele, and ileus were identified in one case each.
(Conclusion) SNNS for early-stage cervical cancer is safe and effective with low rates of recurrence and postoperative complications..