Validation and application of the sentinel lymph node concept in malignant vulvar tumours

Vidal-Sicart, Sergi; Puig-Tintoré, Luis M.; Lejárcegui, J. A.; Paredes, Pilar; Ortega, María Luisa; Muñoz, Antonio; Ordi, Jaume; Fusté, Pere; Ortín, Jaime; Duch, Joan; Martı́n, Francisco; Pons, Françesca

doi:10.1007/s00259-006-0237-9

Cited by 59 publications

(39 citation statements)

References 21 publications

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“…In such cases, only the sensitivity and specificity results can be given for the combination of tests used rather than only blue dye or 99m Tc separately or only both used together in all patients. However, for the other 20 studies, 50,51,[53][54][55][56][57][58][59][60][61][63][64][65][68][69][70][71][72][73][74] detection rates per groin can be given for each test separately and both tests combined (see Table 7). It is noticeable that the histopathological techniques used for the full IFL specimens were either not given or were less detailed than those used for the SLNs.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Meads¹,

Sutton²,

Małysiak³

et al. 2013

Health Technology Assessment

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Meads¹,

Sutton²,

Małysiak³

et al. 2013

Health Technology Assessment

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“…Since the tumor is suitable for injection with a vital blue dye and/or technetium 99m and the lymphatic flow pathway is predictable, vulvar cancer is also a good target for SLN biopsy (4). Since 1994, a great number of clinical trials have been published on SLN detection and accuracy in vulvar cancer (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). In these clinical trials, the accuracy of SLN biopsy using a radiocolloid alone or in combination with a blue dye was demonstrated with a high negative predictive value (95%), but false positive cases were also reported.…”

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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“…Many authors have reported the use of a combination of technetium and blue dye for the SLNB procedure in vulvar CA [25,[32][33][34][35][36][37][38][39][40][41][42]. Rationale behind this practice relates to the importance of identifying the SLNs intra operatively.…”

Section: Slnb Techniquementioning

confidence: 99%

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

McGee

Covens

2009

Womens Health (Lond Engl)

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Treatment for early-stage vulvar carcinoma has evolved from radical en bloc dissection to wide local incision with lymphadenectomy through separate groin incisions, to sentinel lymph node biopsy (SLNB). The morbidity of SLNB is far less than traditional inguinofemoral lymphadenectomy, with less lymphedema and sensory deficit, shorter hospital stays and fewer infections. A multidisciplinary approach is required, with success of the SLNB technique maximized when radiolabeled colloid is used, with blue dye added when further identification is needed. Frozen-section analysis, followed by ultrastaging of the nodal sample, minimizes the need for reoperations and decreases the risk of false negatives. We believe that SLNB will become the standard of care for treatment of early-stage vulvar carcinoma.

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Validation and application of the sentinel lymph node concept in malignant vulvar tumours

Abstract: SLN identification permits the accurate pathological study of regional nodes and could reduce the high morbidity of current surgical treatment in vulvar tumour patients if the technique were to be adopted on a routine clinical basis.

Cited by 59 publications

References 21 publications

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

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

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

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