SLN biopsy in cervical cancer patients with tumors larger than 2 cm and 4 cm.

Objectives The aim of this study was to assess the detection rate, false-negative rate and sensitivity of SLN in LN staging in tumors over 2 cm on a large cohort of patients. Methods Data from patients with stages pT1a – pT2 cervical cancer who underwent surgical treatment, including SLN biopsy followed by systematic pelvic lymphadenectomy, were retrospectively analyzed. A combined technique with blue dye and radiocolloid was modified in larger tumors to inject the tracer into the residual cervical stroma. Results The study included 350 patients with stages pT1a - pT2. Macrometastases, micrometastases, and isolated tumor cells were found in 10%, 8%, and 4% of cases. Bilateral detection rate was similar in subgroups with tumors < 2 cm, 2–3.9 cm, and ≥ 4 cm (79%, 83%, 76%) (P = 0.460). There were only two cases with false-negative SLN ultrastaging for pelvic LN status among those with bilateral SLN detection. The false negative rate was very low in all three subgroups of different tumor sizes (0.9%, 0.9%, and 0.0%; P = 0.999). Sensitivity reached 96% in the whole group and was high in all three groups (93%, 93%, 100%; P = 0.510). Conclusions If the tracer application technique is adjusted in larger tumors, SLN biopsy can be equally reliable in pelvic LN staging in tumors smaller and larger than 2 cm. The bilateral detection rate and false negative rate did not differ in subgroups of patients with tumors < 2 cm, 2–3.9 cm, and ≥ 4 cm. [ABSTRACT FROM AUTHOR]