Abstract
The utility of lymphatic mapping and sentinel lymph node biopsy in malignancies of the female lower genital tract—vulvar, vaginal, and cervical cancers—is being explored in multiple centers internationally. For patients with these tumors, lymphatic mapping with sentinel lymph node biopsy holds the promise of increasing the identification of microscopically metastatic disease while decreasing the morbidity of complete lymphadenectomy. In this review article we present the published data on mapping techniques and discuss the advantages and pitfalls of these procedures.
Similar content being viewed by others
References and Recommended Reading
Cabanas RM: An approach for the treatment of penile carcinoma. Cancer 1977, 39:456–466. The first report on lymphatic mapping. Concepts still hold true today.
Uren RF, Howman-Giles R, Thompson JF: Patterns of lymphatic drainage from the skin in patients with melanoma. J Nucl Med 2003, 44:570–582.
Morton DL, Thompson JF, Essner R, et al.: Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lymphadenectomy Trial Group. Ann Surg 1999, 230:453–463. Large trial that helped install lymphatic mapping as standard of care for the treatment of melanoma.
Sanidas EE, de Bree E, Tsiftsis DD: How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer? Am J Surg 2003, 185:202–210.
Cancer statistics, 2005. Cancer 2005, 55:10–30.
Lu KH, Burke TW: Early cervical cancer. Curr Treat Options Oncol 2000, 1:147–155.
Berek J, Hacker N: Practical Gynecologic Oncology, edn 3. Baltimore: Lippincott Williams & Wilkins; 2000.
Burke TW: Treatment options in stage IB cervical cancer: radical hysterectomy and radiotherapy. Semin Radiat Oncol 1994, 4:34–40.
O’Boyle JD, Coleman RL, Bernstein SG, et al.: Intraoperative lymphatic mapping in cervix cancer patients undergoing radical hysterectomy: a pilot study. Gynecol Oncol 2000, 79:238–243.
Marchiole P, Buenerd A, Scoazec JY, et al.: Sentinel lymph node biopsy is not accurate in predicting lymph node status for patients with cervical carcinoma. Cancer 2004, 100:2154–2159.
Malur S, Krause N, Kohler C, Schneider A: Sentinel lymph node detection in patients with cervical cancer. Gynecol Oncol 2001, 80:254–257.
Martinez-Palones JM, Gil-Moreno A, Perez-Benavente MA, et al.: Intraoperative sentinel node identification in early stage cervical cancer using a combination of radiolabeled albumin injection and isosulfan blue dye injection. Gynecol Oncol 2004, 92:845–850.
Dargent D, Enria R: Laparoscopic assessment of the sentinel lymph nodes in early cervical cancer. Technique--preliminary results and future developments. Crit Rev Oncol Hematol 2003, 48:305–310.
Angioli R, Palaia I, Cipriani C, et al.: Role of sentinel lymph node biopsy procedure in cervical cancer: a critical point of view. Gynecol Oncol 2005, 96:504–509.
Lin YS, Tzeng CC, Huang KF, et al.: Sentinel node detection with radiocolloid lymphatic mapping in early invasive cervical cancer. Int J Gynecol Cancer 2005, 15:273–277.
van Dam PA, Hauspy J, Vanderheyden T, et al.: Intraoperative sentinel node identification with Technetium-99m-labeled nanocolloid in patients with cancer of the uterine cervix: a feasibility study. Int J Gynecol Cancer 2003, 13:182–186.
Silva LB, Silva-Filho AL, Traiman P, et al.: Sentinel node detection in cervical cancer with (99m)Tc-phytate. Gynecol Oncol 2005, 97:588–595.
Rhim CC, Park JS, Bae SN, Namkoong SE: Sentinel node biopsy as an indicator for pelvic nodes dissection in early stage cervical cancer. J Korean Med Sci 2002, 17:507–511.
Levenback C, Coleman RL, Burke TW, et al.: Lymphatic mapping and sentinel node identification in patients with cervix cancer undergoing radical hysterectomy and pelvic lymphadenectomy. J Clin Oncol 2002, 20:688–693.
Buist MR, Pijpers RJ, van Lingen et al.: Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer. Gynecol Oncol 2003, 90:290–296.
Barranger E, Cortez A, Uzan S, et al.: Value of intraoperative imprint cytology of sentinel nodes in patients with cervical cancer. Gynecol Oncol 2004, 94:175–180.
Plante M, Renaud MC, Tetu B, et al.: Laparoscopic sentinel node mapping in early-stage cervical cancer. Gynecol Oncol 2003, 91:494–503.
Wydra D, Sawicki S, Bandurski T: The sentinel node in cervical cancer: scintigraphy and laparoscopic gamma probe-guided biopsy. Eur J Nucl Med Mol Imaging 2005, 32:720–721.
Niikura H, Okamura C, Akahira J, et al.: Sentinel lymph node detection in early cervical cancer with combination 99mTc phytate and patent blue. Gynecol Oncol 2004, 94:528–532.
Frumovitz M, Coleman RL, Gayed IW, et al.: Utility of preoperative lymphoscintigraphy in patients undergoing radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Am J Obstet Gynecol 2005, in press.
Rahusen FD, Torrenga H, van Diest PJ, et al.: Predictive factors for metastatic involvement of nonsentinel nodes in patients with breast cancer. Arch Surg 2001, 136:1059–1063.
Reynolds C, Mick R, Donohue JH, et al.: Sentinel lymph node biopsy with metastasis: can axillary dissection be avoided in some patients with breast cancer? J Clin Oncol 1999, 17:1720–1726.
Kamath VJ, Giuliano R, Dauway EL, et al.: Characteristics of the sentinel lymph node in breast cancer predict further involvement of higher-echelon nodes in the axilla: a study to evaluate the need for complete axillary lymph node dissection. Arch Surg 2001, 136:688–692.
Barranger E, Coutant C, Cortez A, Uzan S, Darai E: Sentinel node biopsy is reliable in early-stage cervical cancer but not in locally advanced disease. Ann Oncol 2005, 16:1237–1242.
Thevarajah S, Huston TL, Simmons RM: A comparison of the adverse reactions associated with isosulfan blue versus methylene blue dye in sentinel lymph node biopsy for breast cancer. Am J Surg 2005, 189:236–239.
Coleman RL, Whitten CW, O’Boyle J, Sidhu B: Unexplained decrease in measured oxygen saturation by pulse oximetry following injection of Lymphazurin 1% (isosulfan blue) during a lymphatic mapping procedure. J Surg Oncol 1999, 70:126–129.
Hoskins WJ, Perez CA, Young RC: Principles and Practice of Gynecologic Oncology, edn 3. Baltimore: Lippincott Williams & Wilkins; 2000.
Rodier JF, Janser JC, David E, et al.: Radiopharmaceuticalguided surgery in primary malignant melanoma of the vagina. Gynecol Oncol 1999, 75:308–309.
van Dam P, Sonnemans H, van Dam PJ, et al.: Sentinel node detection in patients with vaginal carcinoma. Gynecol Oncol 2004, 92:89–92.
Abramova L, Parekh J, Irvin WP Jr, et al.: Sentinel node biopsy in vulvar and vaginal melanoma: presentation of six cases and a literature review. Ann Surg Oncol 2002, 9:840–846.
Nakagawa S, Koga K, Kugu K, et al.: The evaluation of the sentinel node successfully conducted in a case of malignant melanoma of the vagina. Gynecol Oncol 2002, 86:387–389.
Levenback C, Coleman RL, Burke TW, et al.: Intraoperative lymphatic mapping and sentinel node identification with blue dye in patients with vulvar cancer. Gynecol Oncol 2001, 83:276–281.
Ansink AC, Sie-Go DM, van der Velden J, et al.: Identification of sentinel lymph nodes in vulvar carcinoma patients with the aid of a patent blue V injection: a multicenter study. Cancer 1999, 86:652–656.
de Hullu JA, Hollema H, Piers DA, et al.: Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva. J Clin Oncol 2000, 18:2811–2816.
Moore RG, Granai CO, Gajewski W, et al.: Pathologic evaluation of inguinal sentinel lymph nodes in vulvar cancer patients: a comparison of immunohistochemical staining versus ultrastaging with hematoxylin and eosin staining. Gynecol Oncol 2003, 91:378–382.
Sliutz G, Reinthaller A, Lantzsch T, et al.: Lymphatic mapping of sentinel nodes in early vulvar cancer. Gynecol Oncol 2002, 84:449–452.
De Cicco C, Sideri M, Bartolomei M, et al.: Sentinel node biopsy in early vulvar cancer. Br J Cancer 2000, 82:295–299.
Sideri M, De Cicco C, Maggioni A, et al.: Detection of sentinel nodes by lymphoscintigraphy and gamma probe guided surgery in vulvar neoplasia. Tumori 2000, 86:359–363.
Puig-Tintore LM, Ordi J, Vidal-Sicart S, et al.: Further data on the usefulness of sentinel lymph node identification and ultrastaging in vulvar squamous cell carcinoma. Gynecol Oncol 2003, 88:29–34.
de Hullu JA, Hollema H, Hoekstra HJ, et al.: Vulvar melanoma: Is there a role for sentinel lymph node biopsy? Cancer 2002, 94:486–491.
Frumovitz M, Ramirez PT, Tortolero-Luna G, et al.: Characteristics of recurrence in patients who underwent lymphatic mapping for vulvar cancer. Gynecol Oncol 2004, 92:205–210.
Louis-Sylvestre C, Evangelista E, Leonard F, et al.: Sentinel node localization should be interpreted with caution in midline vulvar cancer. Gynecol Oncol 2005, 97:151–154.
de Hullu JA, Oonk MH, Ansink AC, et al.: Pitfalls in the sentinel lymph node procedure in vulvar cancer. Gynecol Oncol 2004, 94:10–15.
Levavi H, Sabah G, Hardoff R, et al.: Failure of sentinel node identification following neo-adjuvant chemo-radiotherapy for locally advanced squamous cell carcinoma of the vulva. Eur J Gynaecol Oncol 2003, 24:433–434.
Fons G, ter Rahe B, Sloof G, et al.: Failure in the detection of the sentinel lymph node with a combined technique of radioactive tracer and blue dye in a patient with cancer of the vulva and a single positive lymph node. Gynecol Oncol 2004, 92:981–984.
Terada KY, Shimizu DM, Wong JH: Sentinel node dissection and ultrastaging in squamous cell cancer of the vulva. Gynecol Oncol 2000, 76:40–44.
Tamussino KF, Bader AA, Lax SF, et al.: Groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer. Gynecol Oncol 2002, 86:99–101.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Frumovitz, M., Ramirez, P.T. & Levenback, C. Lymphatic mapping and sentinel node detection in gynecologic malignancies of the lower genital tract. Curr Oncol Rep 7, 435–443 (2005). https://doi.org/10.1007/s11912-005-0008-y
Issue Date:
DOI: https://doi.org/10.1007/s11912-005-0008-y