Sentinel Lymph Node Biopsy for Gynecologic Cancers

IMPORTANCE: Determination of lymph node metastasis is crucial for prognosis and treatment strategies for gynecologic cancers. Assessing metastases using a sentinel lymph node biopsy (SLNBx) approach decreases surgical morbidity and improves quality of life. OBJECTIVE: This review evaluates the efficacy, safety, and clinical utility of SLNB in gynecologic cancers to inform clinical practice and highlight areas for future research. EVIDENCE ACQUISITION: Endometrial, vulvar, cervical, and ovarian cancer studies on SLNB were obtained from databases including PubMed, Scopus, and Web of Science. The search focused on peer-reviewed articles, systematic reviews, meta-analyses, clinical practice guidelines, and expert consensus statements published in English. RESULTS: SLNBx is an effective alternative to systematic lymphadenectomy for staging gynecologic malignancies. It is established for vulvar and endometrial cancer staging. For cervical cancer, the SENTICOL and SENTIX studies demonstrate high detection rates and comparable survival outcomes to lymphadenectomy with fewer comorbidities. In ovarian cancer, SLNBx detection rates vary, and additional research is needed to determine the role of SLNBx. CONCLUSIONS: Clinical studies support the use of SLNBx for staging of endometrial, vulvar, and cervical cancers. Future research and standardized protocols are essential to establish SLNBx as a standard practice in ovarian cancer.