Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study

Levenback, Charles; Ali, Shamshad; Coleman, Robert L.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; Geest, Koen De; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma; Lentz, Samuel S.; Burke, James J.; Le, Linda Van; Trimble, Cornelia L.

doi:10.1200/jco.2011.41.2528

Cited by 345 publications

(255 citation statements)

References 16 publications

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“…The GROINS V and the GOG study reported the safety of the SLN biopsy in selected women with vulvar cancer (23,63). In the study of the GOG, women with squamous cell cancer of the vulva were eligible if the depth of invasion was at least 1 mm, the tumor was limited to the vulva, the primary tumor size was at least 2 cm and not larger than 6 cm and there were not any groin lymph nodes clinically suspicious for metastases.…”

Section: Incidencementioning

confidence: 99%

“…In the study of the GOG, women with squamous cell cancer of the vulva were eligible if the depth of invasion was at least 1 mm, the tumor was limited to the vulva, the primary tumor size was at least 2 cm and not larger than 6 cm and there were not any groin lymph nodes clinically suspicious for metastases. Women underwent SLN biopsy and inguinal femoral lymphadenectomy, the sensitivity was 91.7% and the falsenegative rate was 3.7% (63).…”

Section: Incidencementioning

confidence: 99%

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Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia

Zanfagnin

Daniele

et al. 2017

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Section: Incidencementioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia

Zanfagnin

Daniele

et al. 2017

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“…As presented here, all patients with lymph node metastases died and had a significantly shorter survival compared to women without lymph node metastases. Two large studies revealed that sentinel node procedures can be performed in women presenting with a unifocal disease, a tumour size below 4 cm and clinically negative lymph nodes [11,12]. All cases but one in this study had tumour sizes exceeding 5 cm, and five women had clinically enlarged lymph nodes, with two women revealing no metastases in the final histology report.…”

Section: Discussionmentioning

confidence: 59%

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

et al. 2015

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Vulva cancer is the fourth leading gynaecological malignancy, accounting for approximately 4 % of all gynaecological cancers. Surgery represents the treatment of choice, and cases of advanced or recurrent vulvar cancers are to date a major challenge to multidisciplinary teams. Abdominoperineal excision (APE) in combination with vulvectomy and inguinal lymphadenectomy is the only curative treatment option. Patients' files of all women with squamous cell carcinoma of the vulva who underwent abdominoperineal resection were retrospectively reviewed with special regards to technical challenges the general surgeon will face. Seven women were enrolled in this retrospective study with a median age of 71 years (range 56-79 years). In six patients, the pelvic floor after abdominoperineal excision could be closed by direct suture of the levator muscles. One woman underwent abdominoperineal resection with closure of the defect using a vertical rectus abdominis myocutaneous (VRAM) flap. All women underwent radical vulvectomy, in five patients in combination with bilateral inguinal lymph node dissection. Operation time was 377 min (range 130-505 min). The median overall survival after surgery was 27 months (range 4-84 months), with a calculated 5-year survival rate of 42 %. Women with negative lymph nodes revealed a longer survival time after surgery compared to women with lymph node metastases (15.5 vs. 72 months; p=0.09). Abdominoperineal excisions represent a powerful tool in the multidisciplinary treatment regimen of advanced or recurrent vulvar cancer. Reconstruction of the pelvic floor usually does not require myocutaneous flaps, even when facing large tumours. Despite high complication rates, radical surgery was a feasible treatment with long-term survival potential without mortality.

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“…Despite these more conservative surgeries, significant morbidity has persisted. Although wound complications are generally short-lived, lymphedema is a chronic problem which requires long-term management (4). Recently, sentinel lymph node (SLN) biopsy has been introduced as an alternative in order to adequately assess for regional lymph node metastasis and to avoid the morbidity of complete inguinofemoral lymphadenectomy.…”

Section: Introductionmentioning

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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Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study

Cited by 345 publications

References 16 publications

Lower Body Lymphedema in Patients with Gynecologic Cancer

Lower Body Lymphedema in Patients with Gynecologic Cancer

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

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

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