Sentinel lymph node (SLN) biopsy in early cervical cancer uses technetium-99m sulfur colloid ± indocyanine green. The SLN concept in cervical cancer primarily drains to which nodal station first?

• A Common iliac nodes
• B Para-aortic nodes
• C Obturator and internal iliac nodes ✓
• D Deep inguinal nodes

Explanation

The primary sentinel lymph node drainage from the cervix follows the parametrial and uterine vessels to the obturator fossa and internal iliac nodal groups as first echelon nodes. External iliac nodes are commonly second-echelon. The SLN biopsy technique in cervical cancer (SENTICOL trials, SENTIX trial) involves bilateral cervical injection at 3 and 9 o'clock with tracer, then intraoperative detection of first-draining nodes, which are most consistently found in the obturator and internal iliac regions. Para-aortic and common iliac nodes are not typically first-echelon.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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