A systematic review of the accuracy of diagnostic tests for inguinal lymph node status in vulvar cancer

Selman, Tara; Luesley, David; Acheson, Nigel; Khan, Khalid S.; Mann, Christopher H.

doi:10.1016/j.ygyno.2005.05.029

Cited by 78 publications

(52 citation statements)

References 33 publications

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“…In a meta-analysis of studies investigating methods of detecting lymph node metastases in vulvar cancer, SLN dissection was found to be the most accurate way of diagnosing lymph node status (sensitivity of 97%). Other alternative approaches to detect lymph nodes, like groin ultrasound with or without fine needle aspiration, computerized tomography, magnetic resonance imaging and positron emission tomography had sensitivities ranging from 45% to 86% (22). SLN dissection was introduced in order to adequately predict the status of other non-sentinel lymph nodes and to decrease the complications of aggressive surgery.…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey

Boran¹,

Cırık²,

Isikdogan³

et al. 2013

J Turkish German Gynecol Assoc

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Objective:To explore the accuracy of sentinel lymph node (SLN) dissection in predicting regional lymph node status by using either only Technetium-99m-labelled (Tc-99m) or in combination with a blue dye in patients with squamous cell cancer of vulva. Material and Methods:Twenty-one patients who had T1 (≤2 cm) or T2 (>2cm) tumors that did not encroach into the urethra, vagina or anus were included in the study. For the first twelve patients, Tc-99m was used for SLN identification, and the combined technique was used in subsequent patients. Preoperatively, Tc-99m and a blue dye was injected intradermally around the tumor. Following SLN dissection, complete inguinofemoral lymphadenectomy was performed. Results:We could detect SLN in all 21 patients (100%) by either Tc99m or the combined method. SLN was found to be histopathologically negative in 13 groins via Tc-99m and 10 groins via the combined method. Twenty-one of these 23 (91.3%) groin non-SLN were also negative, but in two groins, we detected metastatic non-SLN. Conclusion:Although SLN dissection appears promising in vulvar cancer, false negative cases are reported in the literature. Sentinel lymph node dissection without complete lymphadenectomy does not seem appropriate for routine clinical use, since it is known that groin metastasis is fatal. (J Turkish-German Gynecol Assoc 2013; 14: 146-52) Key words: Sentinel node, lymph node, vulvar cancer Received: 30 May, 2013 Accepted: 18 July, 2013 Amaç: Vulva kanserli hastalarda teknesyum-99m (Tc-99m) veya mavi boya (blue dye) kullanılarak yapılan sentinel lenf nodu (SLN) diseksiyonlarının hastaların lenf nodu tutulumların göstermedeki başarısını belirlemek. Gereç ve Original Investigation 146 IntroductionVulvar squamous cell cancer is a disease of postmenopausal women, with a median age at diagnosis of about 65 years. It accounts for about 4% of genital tract cancers. The increase in incidence of vulvar intraepithelial neoplasia and life span has brought vulvar cancer into a place of more importance among genital tract cancers (1). Lymphatic spread to the inguinal and femoral lymph nodes is the major pathway of invasion in early stage vulvar cancer. The status of the regional lymph nodes is clearly the most important prognostic factor in vulvar cancer.

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Section: Discussionmentioning

confidence: 99%

Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey

Boran¹,

Cırık²,

Isikdogan³

et al. 2013

J Turkish German Gynecol Assoc

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“…En modern ve gelecek vadeden yöntemin ise SLN biyopsisi olduğu düşü-nülmektedir. 1 Levenback ve ark.nın 1995 yılında intraoperatif lenfatik haritalama amaçlı izosulfan mavi boyanın kullanıldığı 21 olguyu inceledikleri ça-lışmada, intraoperatif SLN yakalama oranının %62 ve bu SLN'lerinin spesifisitesi ve sensitivitesinin ise %100 olduğunu raporlanmıştır. Olgularda yalancı negatiflik bildirilmemiştir.…”

Section: Vulva Kanseri̇unclassified

Application of Sentinel Lymph Node Dissection in Gynecologic Cancers: Review

Balci¹,

Köşüş²,

Kaygusuz³

et al. 2015

Turkiye Klinikleri J Gynecol Obst

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“…11 The SLN identification by a technetium99m-labelled nanocolloid (alone or with blue dye) appears to be the most accurate method, with a sensitivity of 97% as reported for pooled data published between 1979 and 2004. 12 Positive non-sentinel nodes (NSLN) in the presence of negative SLN (i.e. false-negative SLN)…”

Section: Introductionmentioning

confidence: 99%

“…12 The SLN procedure leads to a significant reduction in short term (wound breakdown, cellulitis) and long term morbidity (lymphedema, recurrent erysipeles) compared to ILND. 13…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intra-operative mapping with technetium-99m-labeled nanocolloid

Klar

Bossart

Stickeler

et al. 2011

European Journal of Surgical Oncology (EJSO)

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To cite this version:M. Klar, M. Bossart, E. Stickeler, I. Brink, M. Orlowska-Volk, et al.. Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intraoperative mapping with technetium-99m-labeled nanocolloid. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (9) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT Key words /MeSH terms:Vulvar carcinoma, sentinel lymph node, technetium-99m nanocolloid Conflict of interestThe authors declare no conflict of interest M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 Abstract Aims:Sentinel lymph node (SLN) mapping appears to be feasible in patients with primary vulvar cancer. Previous protocols describe the injection of the technetium-99m-nanocolloid at least 3 hours before surgery which involves two invasive procedures for the patient. In this study, we assessed the feasibility, safety, and accuracy of an intraoperative rather than preoperative SLN mapping in patients with primary vulvar cancer. Methods:Patients with histologically confirmed squamous cell vulvar cancer and clinically FIGO stage Ib disease underwent intraoperative SLN mapping by intradermal injection of the nanocolloid around the tumor. SLN were identified and removed before a complete inguino-femoral lymphnode dissection was performed. Surgical and pathologic data on all patients were prospectively entered into a database. Results:A SLN procedure was performed in 16 patients; 3 patients received unilateral lymphadenectomy, and 13 women underwent surgery on both groins. In all groins but 4 at least one SLN was clearly identified (detection rate 25/29, 86%). A median number of 2 SLN and 4 non-SLN per groin were removed. 3 of 16 patients (19 %) had metastatic disease in the lymph nodes. There was no false negative SLN result. Conclusion:Intraoperative SLN detection seems feasible in patients with early stage vulvar cancer. More patients need to be enrolled in this ongoing study before this more convenient technique can be considered safe.

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A systematic review of the accuracy of diagnostic tests for inguinal lymph node status in vulvar cancer

Cited by 78 publications

References 33 publications

Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey

Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey

Application of Sentinel Lymph Node Dissection in Gynecologic Cancers: Review

Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intra-operative mapping with technetium-99m-labeled nanocolloid

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