Background: The objective of this study was to determine clinical, tumor and surgical factors associated with sucessful bilateral sentinel lymph node mapping (SBM) in early-stage cervical cancer.
Methods: We performed an ancillary work on the data of two prospective trials on SLN biopsy for FIGO IA-IIA cervical cancer (SENTICOL I & II). Patients having Sentinel lymph node (SLN) mapping for early-stage cervical cancer were included between 2005 and 2012 from 28 French oncologic centers. SLN was detected by a combined labeling technique (blue and isotopic).
Results : 405 patients were included for analysis : SLNs were identified on at least one side of the pelvis in 381 patients (94.1%) and bilaterally in 326 patients (80.5%). The mean age was 45.4 years [22-85 years]. Most patients had IB1 pathologic FIGO 2018 stage (81.3%) and squamous cells carcinoma (71%). Surgeries were mainly performed by mini-invasive approach (368 patients – 90.9%). By multivariate analysis, lower SBM rate was significantly associated with Age ≥ 70 years (ORa=0.02, 95%CI=[0.002 – 0.29], p = 0.003), tumor size larger than 20 mm (ORa=0.41, 95%CI=[0.19 – 0.87], p = 0.02) and Body-mass index higher than 30 kg/m2 (ORa=0.33, 95%CI=[0.15 – 0.75], p = 0.01). During the inclusion period 2009-2012, SBM was significantly better than during inclusion period 2005-2007 (ORa=2.24, 95%CI=[1.09 – 4.61], p < 0.03).
Conclusions:  In early-stage cervical cancer, bilateral SLN detection rates is lower in patients aged more than 70 years, obese patients and larger tumor ≥ 20 mm whereas stronger experience of SLN biopsy technique improves bilateral SLN detection.

Predictive factors associated with successful bilateral Sentinel Lymph Node mapping in early-stage cervical cancer