Detection of sentinel lymph node in laparoscopic surgery for uterine cervical cancer using carbon nanoparticles

J Surg Oncol. 2020 Oct;122(5):934-940. doi: 10.1002/jso.26100. Epub 2020 Jul 2.

Abstract

Background and objectives: Carbon nanoparticles (CNPs) has been widely confirmed the efficiency in sentinel lymph node (SLN) mapping for various solid tumors. This study aims to explore the feasibility and effectiveness of CNPs during laparoscopic surgery for cervical cancer.

Methods: We analyzed 45 women with stage IB1-IIA1 cervical cancer who underwent SLN mapping using CNPs during laparoscopic surgery. The effectiveness of CNPs was evaluated by the detection rate and accuracy parameters. Factors associated with SLN laterality and SLNs localizations were analyzed.

Results: The overall and bilateral detection rate was 93.3% (42/45) and 60.0% (27/45), respectively. Elevated body mass index was associated with decreased bilateral detection rate (P = .015). A total of 225 SLNs were harvested, with a mean number of 5.0 ± 3.6. A total of 81.3% of SLNs were in expected localizations including external iliac (39.1%), internal iliac (25.8%), and obturator (16.4%) regions, while 18.7% in unusual localizations including common iliac (10.7%), parametrial (7.6%), and presarcal (0.4%) regions. None positive lymph node was found in non-SLNs with a false-negative rate of 0%.

Conclusion: Laparoscopic SLN mapping with CNPs appears to be simple and efficient for patients with early-stage cervical cancer.

Keywords: body mass index; carbon nanoparticles; cervical cancer; minimally invasive surgery; sentinel lymph node.

MeSH terms

  • Adult
  • Carbon / administration & dosage*
  • Carbon / chemistry
  • Feasibility Studies
  • Female
  • Humans
  • Hysterectomy
  • Laparoscopy / methods
  • Lymph Node Excision
  • Middle Aged
  • Nanoparticles / administration & dosage*
  • Nanoparticles / chemistry
  • Neoplasm Staging
  • Sentinel Lymph Node / pathology*
  • Sentinel Lymph Node / surgery
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery*

Substances

  • Carbon