Research Papers:

Abdominal radical trachelectomy guided by sentinel lymph node biopsy for stage IB1 cervical cancer with tumors >2 cm

Xiangyun Deng _, Ying Zhang, Dapeng Li, Xiaoling Zhang, Hui Guo, Fei Wang and Xiugui Sheng

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Oncotarget. 2017; 8:3422-3429. https://doi.org/10.18632/oncotarget.13788

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Xiangyun Deng1,2,3, Ying Zhang1,2,3, Dapeng Li2,3, Xiaoling Zhang2,3, Hui Guo1,2,3, Fei Wang1,2,3, Xiugui Sheng2,3

1School of Medicine and Life Sciences, University of Jinan, Jinan 250022, Shandong, People’s Republic of China

2Shandong Academy of Medical Sciences, Jinan 250000, Shandong, People’s Republic of China

3Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, Shandong, People’s Republic of China

Correspondence to:

Xiugui Sheng, email: [email protected]

Keywords: cervical cancer, tumor >2 cm, abdominal radical trachelectomy, sentinel lymph node, oncological outcomes

Received: March 01, 2016    Accepted: November 21, 2016    Published: December 03, 2016


Accuracy of prediction of pelvic lymph node status using sentinel lymph node biopsy (SLNB), and outcomes of SLNB-guided abdominal radical trachelectomy (ART) were assessed. Patients with stage IB1 (Figure 2009) cervical cancer and with tumors >2 cm were enrolled. Prior to fertility-sparing surgery 99mTc-labeled phytate was administered. SLNs were intraoperatively identified, excised, and assessed using fast-frozen sections. Systematic bilateral pelvic lymphadenectomy with or without para-aortic lymphadenectomy was subsequently undertaken. The SLN detection rate was 91.8% (45/49 patients); 8.2% (4/49) had radical hysterectomies because of metastatic primary SLNs. All SLNs received routine immunopathological examination to detect micrometastasis. Sensitivity, accuracy, and false negative rates were 100%, 100%, and 0%, respectively. ART was successfully completed in 45 patients (median follow-up, 61 [range, 4–149] months). Three of the 45 (6.7%) were lost to follow-up; two relapsed and one died of tumor progression. Overall 3-year survival and progression-free survival rates were 97.6% and 95.2%, respectively. Of the 19 patients who attempted to conceive after surgery, five achieved pregnancy, and one had a live birth in the third trimester. We concluded that SLNB using 99mTc-labeled phytate can accurately assess pelvic node status. SLNB-guided ART is safe and feasible in patients selected for fertility-sparing procedures.

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