Lymphatic Mapping of Sentinel Nodes in Early Vulvar Cancer

Sliutz, Gerhard; Reinthaller, Alexander; Lantzsch, Tilmann; Mende, T; Sinzinger, H.; Kainz, Ch.; Koelbl, Heinz

doi:10.1006/gyno.2001.6572

Cited by 108 publications

(42 citation statements)

References 17 publications

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“…Since then, technetium-99m-labelled colloid (Tc99m) with or without blue dye is applied with very high detection rates of the sentinel lymph node ranging up to 100% [De Cicco et al 2000;Sliutz et al 2002]. Nevertheless, due to poor prognosis after groin recurrence, false-negative results during initial surgery have to be strictly avoided.…”

Section: Recommendations For Groin Surgery In Early-stage Vulvar Cancermentioning

confidence: 99%

Management of patients with vulvar cancer: a perspective review according to tumour stage

et al. 2013

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Treatment of patients with vulvar cancer is challenging for gynaecologic oncologists. Owing to the localization in a sensitive area, surgical radicality and the indication for adjuvant treatment have to be balanced with psychosocial aspects to treat patients adequately. Clinical management is therefore highly dependent on the tumour stage. For patients with early-stage disease (FIGO I-II) therapy mainly concentrates on surgery with resection of the primary tumour and staging of the groin lymph nodes. In intermediate-stage vulvar cancer (FIGO III), advanced disease is expressed by affected inguinofemoral lymph nodes bringing radical lymphadenectomy and adjuvant therapy as well as radiation or chemoradiation into the focus of treatment. For locally advanced or metastatic vulvar cancer (FIGO IV) neoadjuvant or definitive chemoradiation has to be considered besides surgery. Owing to the low incidence of the disease, the level of evidence for different treatment modalities is poor. This review therefore puts different recommendations of clinical management in context and highlights the need for future trials.

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Section: Recommendations For Groin Surgery In Early-stage Vulvar Cancermentioning

confidence: 99%

Management of patients with vulvar cancer: a perspective review according to tumour stage

et al. 2013

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“…In the other 65-75% this intervention will (in retrospect) probably be only diagnostic. In order to reduce morbidity the sentinel lymph node (SLN) procedure was introduced in vulvar cancer treatment with promising results in different accuracy-studies [3][4][5][6][7][8][9][10]. Its safety has recently been shown in the Groningen International Study on Sentinel Nodes in Vulvar cancer (GROINSS-V) with a false negative rate of 2.8% in patients with unifocal early stage disease [11].…”

Section: Introductionmentioning

confidence: 99%

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Oonk

Bock

et al. 2009

Gynecologic Oncology

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A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy Oonk, M. H. M.; van Os, M. A.; de Bock, G. H.; de Hullu, J. A.; Ansink, A. C.; van der Zee, A. G. J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Objectives. The SLN-procedure has been introduced in vulvar cancer treatment to reduce morbidity and thereby improve quality of life. Aim of this study was to compare quality of life in vulvar cancer patients who were treated with a SLN-procedure only to those who underwent inguinofemoral lymphadenectomy. Moreover, it was evaluated what patients would advise relatives on the application of the SLN-procedure in light of possible false negative results.Methods. Patients who participated in the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) were invited to fill out three questionnaires: the EORTC QLQ-C30, a vulvar specific questionnaire and a questionnaire about the opinion of patients on new treatment options. Patients who only underwent SLN-procedure were compared to those who subsequently underwent inguinofemoral lymphadenectomy because of a positive SLN.Results. With a response rate of 85%, 35 patients after the SLN-procedure and 27 patients after inguinofemoral lymphadenectomy filled out the questionnaires. No difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of lymphedema of the legs after inguinofemoral lymphadenectomy. The majority of patients would advise the SLN-procedure to relatives. Patients after inguinofemoral lymphadenectomy were more reserved concerning the acceptable false negative rate of a new diagnostic procedure.Conclusions. Patients who underwent the SLN-procedure report less treatment related morbidity compared to those who underwent inguinofemoral lymphadenectomy. However, this did not influence overall quality of life. Furthermore, patients who underwent inguinofemoral lymphadenectomy are more reserved in advising the SLN-procedure to relatives.

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“…Studies in vulvar cancer in which SLN detection was followed by a completion inguinofemoral lymphadenectomy suggest that the SLN procedure is highly accurate in identifying lymph node metastases with an NPV approaching 100% [24,25,29,30,38,40,[65][66][67][68][69][70][71][72][73]. Table 1 illustrates selected studies on this subject.…”

Section: Squamous Cell Vulvar Carcinomamentioning

confidence: 99%

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

et al. 2009

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The treatment of gynecologic malignancies can include surgery, systemic therapy, and radiation. Depending on the primary site of disease and the extent of the disease, these treatment strategies are applied alone or in combination.Trends over the past few decades have concentrated on performing more comprehensive staging procedures for a large percentage of patients with gynecologic malignancies. The surgical techniques available for comprehensive staging have facilitated a greater understanding of stage and prognosis overall, and better tailoring of postsurgical treatment.One such technique is regional lymphadenectomy. Although the role of regional lymphadenectomy as a therapeutic procedure in some gynecologic cancers is debated and challenged (regional lymphadenectomy and multimodality therapy increases adverse side effects and long-term sequelae without proven survival benefit), there is no controversy regarding the staging and prognostic benefit of the evaluation of regional lymph nodes. The sentinel lymph node (SLN) concept was successfully introduced in melanoma. It has since become the standard of care in breast cancer and has had a significant impact on postoperative morbidity for a large percentage of breast cancer patients. Interest in using SLN techniques in gynecologic cancers was thus a natural progression. In light of the growing body of evidence in the literature opposing the therapeutic benefit of systematic lymphadenectomy, the SLN concept will continue to play an important role in the treatment of gynecologic malignancies. This technique can provide accurate staging information in some gynecologic cancers. Increased use of this technique could potentially impact the quality of life of gynecologic cancer survivors while still providing important staging information without compromising oncologic safety.In this review, we examine the body of literature related to gynecologic cancer malignancies and SLN biopsy. The Oncologist 2009;14:695-705

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Lymphatic Mapping of Sentinel Nodes in Early Vulvar Cancer

Cited by 108 publications

References 17 publications

Management of patients with vulvar cancer: a perspective review according to tumour stage

Management of patients with vulvar cancer: a perspective review according to tumour stage

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

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