• 43% of cases with N1 (macrometastasis, micrometastasis) are detected by pathological ultrastaging of SLN.

• The detection rate of SLN metastatic involvement correlates with the number of levels assessed by ultrastaging.

• Four levels should become the international standard, detecting over 90% of N1 cases.

Sentinel lymph node pathological ultrastaging

• Ultrasound is as accurate as MRI in preoperative pelvic staging of cervical cancer

• US and MRI not differ in the assessment of tumour size and parametrial involvement

• US can be reliably used for pretreatment triage of cervical cancer patients

• US examination represents a reliable solution for limited resource countries

MRI and ultrasound in preoperative pelvic staging

• SLNB does not eliminate the risk of mild to moderate lymphedema (26%).

• Replacing standard PLND with bilateral SLN biopsy significantly reduces the rate of subjectively reported lower limb swelling

Lower limb lymphoedema after SLN biopsy

• Very high bilateral SLN detection success rate = 93%

• 97% of SLNs located distal to the interiliac bifurcation – only 1.3% of positive SLNs found outside this area

• Half of pN1 cases not identified intraoperatively

Sentinel lymph node maping and intraoperative assessment

• Postoperative bladder emptying dysfunction is related to the radicality of parametrectomy.

• Severe urinary dysfunctions persisting more than one month were described in only 1% of patients.

Voiding recovery after radical parametrectomy

• Central quality control of SLN pathological processing using ultrastaging

• Quality improvement during the course of the study.

Central pathology review