[Lymph node mapping and sentinel node detection in carcinoma of the cervix, endometrium and vulva]

OBJECTIVES

Validity of the sentinel node concept in patients with cervical, endometrial and vulvar cancer.

MATERIAL AND METHODS

47 cases of FIGO stage I and II cervical cancer, 33 cases of first clinical stage of endometrial cancer and 37 patients with FIGO stage I and II of vulvar cancer. In cervical and vulvar cancer preoperative lymphoscyntygraphy and intraoperative lymphatic mapping with blue dye and handheld gamma probe were performed. In patients with endometrial cancer intraoperative lymphatic mapping with blue dye injected into the cervix and into the uterine corpus subserously were done. In the last 10 cases radiolabeled nannocolloid were administered and the patients underwent preoperative lymphoscyntygraphy and intraoperative radio detection of sentinel node. Sentinel nodes were labeled as blue, radioactive, or blue/radioactive.

RESULTS

In cervical cancer sensitivity of the dye and radiocolloid methods was 94%, specificity 100% and negative predictive value 97%. Out of 33 cases of endometrial cancer sentinel node was identified in 29 (87.87%) patients. None of women with histological negative sentinel node had metastases in the rest of lymph nodes resected. Sentinel node was detected in all cases of vulvar cancer. The status of sentinel nodes were representative for all lymph node resected.

CONCLUSIONS

Concept of sentinel node may be applied first of all for vulvar cancer and also for cervical and endometrial cancer.

[Operative treatment of early cancerous stages and a woman's quality of life]

The operative treatment of early cervical cancerous stages changes the womans quality of life. In the literature there exist works on influence of radical treatment of invasive cervical cancer on the psychical and psychological state of the operated woman. There are few works on the influence of early cancerous stages and social activity of woman. The aim of this work is the assessment of influence of precancerous and cancerous cervical disease of psychical state, partnership, family life and professional and social activity of woman. The material were 153 women aged 20-47 years diagnosed and treated in the Department of Gynaecology and Oncology CM UJ Krakow in the period 1989-1994 for CIN 3 and the cervical cancer in IA stage. During the hospitalisation the women were tested psychologically and were performed special examination with originally constructed formula in 3, 6 and 12 month after the treatment. There has been stated that the precancerous and early cancerous disease diagnosis causes the disease awareness in these women who stated themselves as healthy, causes the fear of the life and saving the reproductive organ and protection the reproduction ability, their further family, professional activities i.e. woman's quality of life.