Validación de la técnica de ganglio centinela en cáncer de cuello uterino en el Hospital de la Mujer

Sebastián Ben; María Fernanda Nozar; Diego Greif; Josefina Tarigo; Valeria Tolosa; Nelson Martínez; Lucía Castelgrande; Gualberto Arribeltz; Benedicta Caserta

doi:10.29193/RMU.40.2.8

Authors

Sebastián Ben Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica A, Prof. Adj. https://orcid.org/0000-0001-7664-4687
María Fernanda Nozar Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica A, Prof. Agda. https://orcid.org/0000-0003-2820-2141
Diego Greif Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica B, Prof. Agdo. https://orcid.org/0000-0003-1332-4314
Josefina Tarigo Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica A, Prof. Adj. https://orcid.org/0000-0003-0440-0581
Valeria Tolosa Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica A, Asistente https://orcid.org/0009-0005-3684-0321
Nelson Martínez Hospital de la Mujer, Unidad de Ginecología Oncológica, Ginecólogo https://orcid.org/0009-0003-1742-0247
Lucía Castelgrande Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica A, Residente https://orcid.org/0009-0008-8352-4921
Gualberto Arribeltz Universidad de la República, Facultad de Medicina, Clínica Ginecotocológica A, Ex Prof. Agdo. https://orcid.org/0000-0002-5427-6788
Benedicta Caserta Universidad de la República, Facultad de Medicina, Departamento de Anatomía Patológica, Prof. Agda. Hospital de la Mujer, Departamento de Anatomía Patológica y Citología, Jefa https://orcid.org/0000-0001-7901-9692

DOI:

https://doi.org/10.29193/RMU.40.2.8

Keywords:

CERVIX, CERVICAL CÁNCER, SENTINEL LYMPH NODE, VALIDATION STUDY, VALIDATION OF DIAGNOSTIC TECHNIQUE

Abstract

Introduction: Cervical cancer (CC) is a public health problem. In Uruguay, it ranks third in incidence in women, causing 133 deaths annually. Lymph node involvement is one of its main prognostic factors and determines treatment. The sentinel lymph node (SLN) in early stages of cervical cancer is a safe technique that allows for adequate staging and reduces morbidity associated with conventional lymphadenectomy.
Objective: To validate the use of the SLN biopsy technique in early stages of CC as the standard treatment for detecting lymph node metastases at the Women’s Hospital.
Method: A prospective, longitudinal case study was conducted. Thirty patients with early-stage cervical cancer between January 2018 and November 2022 were included in the study. The marking was done with Tc99. Systematic pelvic lymphadenectomy was performed in the same surgical procedure.
Results: Sentinel lymph nodes were detected bilaterally in 29 out of 30 patients. With a detection rate per region of 98.3%, metastatic SLNs were detected in 5 patients, with no positive non-sentinel nodes found. One of them corresponded to a micrometastasis detected by ultra-staging. Sensitivity was 100% (95% CI 56.55,100) with a negative predictive value of 100% (95% CI 86.68, 100).
Conclusions: According to the results of the study, the interdisciplinary team at the Women’s Hospital is in a position to use cervical SLN biopsy as the standard treatment for early-stage cervical cancer.

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