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首页> 外文期刊>Gynecologie, obstetrique & fertilit >Role of sentinel node biopsy in early-stage cervical cancer in the therapeutic strategy
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Role of sentinel node biopsy in early-stage cervical cancer in the therapeutic strategy

机译：前哨淋巴结活检在早期宫颈癌治疗策略中的作用

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摘要

Early-stage cervical cancer (IA2 and IB1) treatment consists in surgery with a radical colpohysterectomy associated to a systematic pelvic lymphadenectomy more or less a paraaortic lymphadenectomy (Wertheim-Meigs surgery). Pelvic lymph node involvement is the main independent prognostic factor and justifies an adjuvant therapy. Sentinel lymph node (SLN) procedure allows a reliable evaluation of the lymph node status thanks to an accurate histologic analysis. This procedure is still not validated in practice, which means the bilateral pelvic lymphadenectomy is systematically done whatever the lymph node status is. Nevertheless the purpose of the SLN biopsy in cervical cancer does not consist in avoiding an unnecessary lymphadenectomy, which is not really associated with a major morbidity. Actually, a better initial stadification would allow to fit to the risk of recurrence not only the radicality of the surgery, but also the adjuvant therapy. The morbidity of a radical surgery could be limited for good prognosis patients and avoided for the benefit of a concomitant chemoradiotherapy.
机译：早期宫颈癌（IA2和IB1）的治疗方法是进行根治性结肠全子宫切除术，而该手术与系统性盆腔淋巴结清扫术或多或少地行主动脉旁淋巴结清扫术（Wertheim-Meigs手术）有关。盆腔淋巴结受累是主要的独立预后因素，并证明了辅助治疗的合理性。前哨淋巴结（SLN）程序通过准确的组织学分析可以对淋巴结状态进行可靠的评估。该程序在实践中仍未得到验证，这意味着无论淋巴结状况如何，都将系统地进行双侧盆腔淋巴结清扫术。尽管如此，SLN活检在宫颈癌中的目的并不在于避免不必要的淋巴结清扫术，而这实际上与主要的发病率无关。实际上，更好的初始治疗方法不仅可以适应手术的彻底性，还可以适应辅助治疗的复发风险。对于预后良好的患者，根治性手术的发病率可能会受到限制，而伴随放化疗的好处则可以避免。

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