Sentinel node biopsy in early vulvar cancer

• Published in: British journal of cancer Vol. 82; no. 2; pp. 295 - 299
• Main Authors: DE CICCO, C, SIDERI, M, PAGANELLI, G, BARTOLOMEL, M, GRANA, C, CREMONESI, M, FIORENZA, M, MAGGIONI, A, BOCCIOLONE, L, MANGIONI, C, COLOMBO, N
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.01.2000
• Subjects: Adult; Biological and medical sciences; Biopsy; Breast cancer; Cancer research; Female; Female genital diseases; Genital cancers; Groin; Gynecology; Gynecology. Andrology. Obstetrics; Humans; Lymph Node Excision; Lymph Nodes - pathology; Lymphatic Metastasis; Lymphatic system; Medical research; Medical sciences; Melanoma; Neoplasm Invasiveness; Oncology; Predictive Value of Tests; Prognosis; Radionuclide Imaging; Regular; Sensitivity and Specificity; Surgery; Tumors; Vulvar Neoplasms - diagnostic imaging; Vulvar Neoplasms - pathology; Italy; Radionuclide study; Human; Squamous cell carcinoma; Prognosis; Lymph node; Sentinel lymph node; Malignant lymphadenopathy; Intraoperative; Early stage; Malignant hemopathy; Vulva; Malignant tumor; Metastasis; Scintigraphy; Female genital diseases; Pathology; Lymphadenectomy; Treatment; Biopsy; Surgery; Gamma camera; Medical imagery; Vulvar diseases
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1054/bjoc.1999.0918

Lymph node pathologic status is the most important prognostic factor in vulvar cancer; however, complete inguinofemoral node dissection is associated with significant morbidity. Lymphoscintigraphy associated with gamma-probe guided surgery reliably detects sentinel nodes in melanoma and breast cancer patients. This study evaluates the feasibility of the surgical identification of sentinel groin nodes using lymphoscintigraphy and a gamma-detecting probe in patients with early vulvar cancer. Technetium-99m-labelled colloid human albumin was administered perilesionally in 37 patients with invasive epidermoid vulvar cancer (T1-T2) and lymphoscintigraphy performed the day before surgery. An intraoperative gamma-detecting probe was used to identify sentinel nodes during surgery. A complete inguinofemoral node dissection was then performed. Sentinel nodes were submitted separately to pathologic evaluation. A total of 55 groins were dissected in 37 patients. Localization of the SN was successful in all cases. Eight cases had positive nodes: in all the sentinel node was positive; the sentinel node was the only positive node in five cases. Twenty-nine patients showed negative sentinel nodes: all of them were negative for lymph node metastases. Lymphoscintigraphy and sentinel-node biopsy under gamma-detecting probe guidance proved to be an easy and reliable method for the detection of sentinel node in early vulvar cancer. This technique may represent a true advance in the direction of less aggressive treatments in patients with vulvar cancer.