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Korean Journal of Obstetrics & Gynecology 2005;48(7):1722-1728.
Published online July 1, 2005.
Study of Factors that Influence Sentinel Lymph Node Identification and Detection Rate in Cervical Cancer of Uterus.
Hyun Park, Seok Ju Seong, Sei Jin Park, Sun Young Kang, In Ho Lee, Hyuk Jun Woo, Je Hoon Lee, Joo Myung Kim, Tae Jin Kim, Kyung Taek Lim, In Sou Park, Jae Uk Shim, Chong Taik Park, Ki Heon Lee, Hye Sun Kim
1Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sjseongcheil@yahoo.co.kr
2Department of Pathology, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
The purpose of this prospective study was to determine the feasibility of sentinel lymph node (SN) identification and to evaluate the factors that influence the sentinel node detection rate in patients with cervical cancer of the uterus. METHODS: Forty three patients underwent intracervical injection of 1% isosulfan blue dye at the time of planned radical hysterectomy and lymphadenectomy between January 2003 and July 2003. With visual detection of blue nodes, SNs were identified and separately removed. And then all patients underwent complete pelvic lymph nodes dissection and/or para-aortic lymph nodes dissection. If frozen sections of the lymph nodes were negative, radical hysterectomy was performed. Tumor characteristics, surgical findings, specific locations of SN and final pathologic results were recorded and correlated with final pathologic results. RESULTS: The mean age of patients was 49.3 years (30-78). SNs were identified in 23 of 43 (53%) patients. About 48.7% of SNs were found in the external iliac region, 31.7% in the obturator region, 17.0% in the internal iliac region and 2.4% in the common iliac region. Metastatic nodes were detected in 11 of 43 (26%) patients. Among 23 patients whose SNs were detected, 5 patients had metastatic nodes while among 20 patients whose SNs were not detected, 8 patients had metastatic nodes. No false negative SN results were obtained. Successful SN detection was more likely performed in patients with preoperative conization (P=0.0156). However, age, stage, histologic type, operation type, and neoadjuvant chemotherapy did not show any significant differences in SN detection rate. CONCLUSION: The identification of the SN with isosulfan blue dye is feasible and safe. SN detection rate was high in patients with preoperative conization. But low detection rate should be further investigated.
Key Words: Sentinel lymph node, Cervical cancer, Isosulfan blue

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