THE PROGNOSTIC INFLUENCE OF SCINTIGRAPHY- GUIDED LYMPHADENECTOMY IN THE THERAPY OF STAGE IB CERVICAL-CANCER

In a retrospective study the survival rates of 161 patients with stage Ib cervical cancer after radical operation (Latzko, Wertheim-Meigs) i ncluding complete or incomplete pelvine lymphadenectomy were compared. To increase radicality of lymphadenectomy, preoperative targeting of pelvic lymph nodes was done in all the patients using (TC)-T-99m-Sb2S3 radiocolloid. Intraoperatively, a gamma-camera being integral part of an operating table allowed delineation and scintigraphy-guided resect ion of pelvic lymph nodes. Dependent on the evidence of remaining pelv ine foci of radioactivity at the end of the operation, lymphadenectomy was assessed as complete or incomplete. Mean observation time of comp letely lymphadenectomised patients(n=117, 72.67%) were 80 months (5-16 9 months) and 42 months (1-149 months) of the incompletely lymphadenec tomised patients (n=44, 27.33%). In 28 (23.93%) completely lymphadenec tomised patients against only 5 (11.36%) patients with incomplete lymp hadenectomy, lymph node metastases were proved histologically. Five ye ar-survival rate of completely lymphadenectomised patients was 85.47% and 88.64% of incompletely lymphadenectomised patients (not significan t, Mantel-Test). Also, selective comparison of lymph node-positive pat ients did not suggest a divergent trend indicated by 13 (46.43%) death s of completely and 3 (60.0%) deaths of the incompletely lymphadenecto mised patients after an observation of five years. The technique of sc intigraphy-guided pelvic lymphadenectomy using Tc-99m-Sb2S3 radiocollo id cannot be expected to improve prognosis of patients with cervical c ancer stage Ib.