Sentinel lymph node sites identified for cervical cancer

In patients with invasive cervical cancer, the most common sentinel node locations are external iliac, obturator and parametrium, according to a study published in the December issue of the American Journal of Obstetrics and Gynecology.

Arnim A. Bader, MD, of the Medical University of Graz in Graz, Austria, and colleagues reviewed 619 patients with invasive cervical cancer who were treated by radical abdominal hysterectomy and systematic pelvic or pelvic and paraaortic lymphadenectomy, including 61 who had one positive lymph node and 59 who had two positive lymph nodes.

The researchers found solitary metastases were most often located in the external iliac and obturator regions and the parametrium (43%, 26%, and 21%, respectively). In patients with two positive nodes, they found the most common combinations were one parametrial and one pelvic node (32%), two ipsilateral positive nodes (31%), or one positive lymph node on each side of the pelvis (27%).

"Sentinel node identification is a convincing concept that will increasingly gain acceptance in cervical cancer," the authors conclude. "Our data of sentinel node localization and investigation of lymphatic spread beyond sentinel nodes may help refine the sentinel technique in cervical cancer."

Bader AA, Winter R, Haas J, et al. Where to look for the sentinel lymph node in cervical cancer. Am J Obstet Gynecol. 2007;197:678.e1-678.e7.