Sentinel Lymph Node Biopsy in Uterine Cervical Cancer Patients: Ready for Clinical Use? A Review of the Literature

Table 1

Summary of clinical trials reviewed that served to validate the importance of sentinel lymph node mapping in cervical cancer patients.

Roca et al. [28]	Sentinel lymph node biopsy is a beneficial technique in order to avoid lymph node dissection in early stages of cervical cancer. It has a high negative predictive value and is simple to be incorporated into clinical routine.
Coutant et al. [29]	Combination of sentinel lymph node biopsy and HPV DNA screening of the excised nodes serves better evaluation of lymph node status and better identification of women at high risk of recurrence.
Altgassen et al. [30]	(i) Systemic lymphadenectomy cannot be omitted from the management of cervical cancer patients.; (ii) Sentinel lymph node biopsy may be profitable for patients with tumour diameter < or = 20 mm.
Darlin et al. [27]	(i) The negative predictive value of sentinel lymph node biopsy reaches 100% in tumours < or = 20 mm and 95% in larger tumours.; (ii) In case of unilateral sentinel lymph node detection, complete lymphadenectomy should be performed on the radionegative side.; (iii) All bulky nodes should be removed.
Gortzak-Uzan et al. [13]	Sentinel lymph node biopsy is a more sensitive procedure in early cervical cancer compared to complete lymphadenectomy (false-negative value = 0%, negative predictive value = 100%).
Vicus and Covens [31]	Sentinel lymph node biopsy techniques improve the detection rate of lymph node metastases by 2.8-fold.
Díaz-Feijoo et al. [32]	SPECT/CT imaging improves the detection rate of lymph node metastases and allows easier intraoperative detection with gamma probe.
Du et al. [14]	(i) Sentinel lymph node biopsy is associated with stage, tumour size, histologic type, preoperative treatment, and history of preoperative conization.; (ii) Sentinel lymph node biopsy has a sensitivity rate of 100%, an accuracy value of 100%, a false-negative predictive value of 0%, and a negative predictive value of 100% in stages IA2–IB1.; (iii) Sentinel lymph node navigation surgery can provide large benefits for selected patients who desire fertility preservation.
Roy et al. [12]	Sentinel lymph node mapping in combination with ultrastaging can identify patients with micrometastases and isolated tumour cells in the nodes and eventually the patients with high risk of recurrence.
Diaz et al. [33]	(i) Sentinel lymph node mapping reduces the morbidity of surgical management of early-stage cervical cancer.; (ii) Sentinel lymph node negative patients are safe to undergo a less radical parametrial resection for small tumour volume.
Devaja et al. [34]	Sentinel lymph node mapping techniques reach a detection rate of 97.5% (73.3% bilaterally), with no false-negative cases and no adverse reactions.
Cibula et al. [35]	(i) In cases of bilateral detection of sentinel nodes, the sentinel lymph node mapping method has a high sensitivity and a low false-negative rate.; (ii) Sentinel lymph node mapping and ultrastaging should become standard practice in the surgical management of early-stage cervical cancer.