![]() Lympho-vascular invasion allows tumor cells to extend through the lymphatic system, crossing first the sentinel nodes before reaching other lymph nodes of the tumor draining lymphatic chain. Lymph node metastasis is an important prognostic factor for gynecological cancer. Keywords: Sentinel lymph node (SLN) ultrastaging metastasis cervical cancer endometrial cancer vulvar cancer vaginal cancer intraoperative frozen section (intraoperative FS) one-step nucleic acid amplification (OSNA ®) This review discusses different histopathological protocols and molecular aspects of SLN evaluation in gynecological cancer. Three sections at 200–250 µm seem to identify the majority of micrometastases. Inclusion of the entire lymph node tissue in paraffin blocks after cutting it in 2 mm thick slices and histopathological ultrastaging with serial sections provides important prognostic information about the need of adjuvant treatment. This reduces the morbidity compared to systematic pelvic and paraaortic lymph node dissection. ![]() If on intraoperative examination on FS the SLN is negative, subsequent analysis of the entire lymph node and histological ultrastadification has the potential to detect occult low volume metastases or to ascertain that a SLN is really negative. Intraoperative FS has a high negative predictive value (NPV) and is more sensitive than imprint cytology (IC) alone. Intraoperative evaluation of the SLN allows to determine the need of completing lymph node dissection in case of metastasis. ![]() Other than in breast cancer and melanoma, frozen section (FS) analysis of SLN in gynecological malignancies is still considered an important diagnostic tool. This review highlights the different ways of histopathological and molecular SLN assessment according to the different gynecological cancers. SLN biopsy has modified the lymph node assessment by pathologists. Interviews with Outstanding Guest EditorsĪbstract: As sentinel lymph nodes (SLNs) are the first nodes receiving drainage from primary tumors, they provide important prognostic information about the nodal status of a tumor.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process.
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