Sentinel node detection by lymphoscintigraphy and sentinel lymph node biopsy in vulvar melanoma

Giuseppe Trifirò, Laura L. Travaini, Francesca Sanvito, Monica Pacifici, Andrew Mallia, Mahila E. Ferrari, Andrea Vertua, Angelo Maggioni, Giovanni Paganelli, Mario G. Sideri

Research output: Contribution to journalArticle

Abstract

Purpose: Vulvar melanoma is a rare malignant tumour. Its surgical excision is the mainstay of treatment whilst the surgical management of regional lymph nodes remains controversial; on the contrary elective inguinofemoral lymphadenectomy causes considerable morbidity. Lymphoscintigraphy (LS) and sentinel lymph node biopsy (SLNB) are accurate staging procedures of lymph node status in breast cancer and cutaneous melanoma patients. In this retrospective paper we report our experience of LS and SLNB in vulvar melanoma patients. Methods: Twenty-two consecutive patients with a diagnosis of vulvar melanoma were treated at our institute: patients with clinically positive groin nodes or with previous surgery on the primary tumour were excluded. Twelve were selected for our analysis. All patients underwent sentinel lymph node localization with LS the day before surgery and the surgical procedure of SLNB associated with radical surgery. Results: Six patients had metastatic SLNB and in five of six (83.3%) it was the only positive node. In the other six patients SLNB was negative for metastatic disease. No skip metastases were observed. In SLNB negative patients the mean Breslow thickness was 2.06 mm (range: 0.60-7.10) and only one patient showed a high Breslow thickness (patient 8). In SLNB positive patients the mean Breslow thickness was 4.33 mm (1.8-6.0). Conclusion: Our data indicate that, even in vulvar melanoma, the sentinel lymph node pathological status predicts the pathological status of the remaining groin nodes and suggests that elective groin dissection can be spared in cases of a negative SLNB. Breslow thickness (

Original languageEnglish
Pages (from-to)736-741
Number of pages6
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume37
Issue number4
DOIs
Publication statusPublished - Apr 2010

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Keywords

  • Lymphadenectomy
  • Lymphoscintigraphy
  • Sentinel node
  • Vulvar melanoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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