TY - JOUR
T1 - Sentinel node mapping with radiotracer alone in vulvar cancer
T2 - A five year single-centre experience and literature review
AU - Bogliolo, S.
AU - Marchiole, P.
AU - Sala, P.
AU - Giardina, E.
AU - Villa, G.
AU - Fulcheri, E.
AU - Menada, M. Valenzano
PY - 2015
Y1 - 2015
N2 - Purpose of investigation: The pathologic status of lymph node represents the most important prognostic factor in vulvar cancer patients, but a complete groin dissection is associated with high post-operative morbidity. Sentinel lymph node (SLN) could be representative of the totality of regional lymph nodes and consequently its biopsy might have a significant impact on clinical management in vulvar cancer patients. Materials and Methods: From January 2006 to December 2010 45 patients with vulvar carcinoma are evaluated. Preoperative lymphatic mapping with technetium-99m-labeled nanocolloid was performed in all patients, followed by radioguided intraoperative detection. The detection rate is 100% of patients. All the SLNs were dissected separately for histopathological evaluation and a routine inguinofemoral lymphadenectomy was performed. Results: Nine patients had positive SLNs. In the remaining 36 patients with negative SLNs, one of them showed positive non-SLNs at histological examination. It was the only false negative case in the present series. Conclusions: Based on literature review, lymphoscintigraphy and sentinel node biopsy under gamma-detecting probe guidance offer a reliable and careful method to identify sentinel node in early vulvar cancer. Taking certain guidelines, SLN biopsy seems to be a safe alternative to inguinofemoral node dissection in order to reduce morbidity of surgical treatment.
AB - Purpose of investigation: The pathologic status of lymph node represents the most important prognostic factor in vulvar cancer patients, but a complete groin dissection is associated with high post-operative morbidity. Sentinel lymph node (SLN) could be representative of the totality of regional lymph nodes and consequently its biopsy might have a significant impact on clinical management in vulvar cancer patients. Materials and Methods: From January 2006 to December 2010 45 patients with vulvar carcinoma are evaluated. Preoperative lymphatic mapping with technetium-99m-labeled nanocolloid was performed in all patients, followed by radioguided intraoperative detection. The detection rate is 100% of patients. All the SLNs were dissected separately for histopathological evaluation and a routine inguinofemoral lymphadenectomy was performed. Results: Nine patients had positive SLNs. In the remaining 36 patients with negative SLNs, one of them showed positive non-SLNs at histological examination. It was the only false negative case in the present series. Conclusions: Based on literature review, lymphoscintigraphy and sentinel node biopsy under gamma-detecting probe guidance offer a reliable and careful method to identify sentinel node in early vulvar cancer. Taking certain guidelines, SLN biopsy seems to be a safe alternative to inguinofemoral node dissection in order to reduce morbidity of surgical treatment.
KW - Groin dissection
KW - Radiotracer
KW - Sentinel-node biopsy
KW - Squamous cells carcinoma
KW - Vulvar cancer
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U2 - 10.12892/ejgo2566.2015
DO - 10.12892/ejgo2566.2015
M3 - Article
C2 - 25872327
AN - SCOPUS:84924662137
VL - 36
SP - 10
EP - 15
JO - European Journal of Gynaecological Oncology
JF - European Journal of Gynaecological Oncology
SN - 0392-2936
IS - 1
ER -