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Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva

J. A. de Hullu, H. Hollema, D. A. Piers, et al.
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

Reviewers: Li Liu, MD
Source: Journal of Clinical Oncology, Volume 18:2811-2816, (August) 2000

Précis: Sentinel lymph node biopsy predicts metastasis of vulvar cancer

Introduction

A sentinel lymph node (SLN) is the first lymph node along the route of lymphatic drainage from a primary tumor. Sentinel lymph nodes receiving lymphatic drainage from a tumor can be removed by limited surgery and examined to determine whether more extensive lymph node dissection was necessary. Sentinel lymph node biopsy carries lower morbidity and cost than a complete lymph node dissection. In this study, the researchers looked at the feasibility of SLN biopsy in patients with squamous cell carcinoma of the vulva.

Method

A total of 59 patients with primary early-stage vulvar cancer underwent SLN biopsy. The researchers then performed radical excision of the primary tumor with inguinofemoral lymphadenectomy to verify their results.

Results

  • SLN biopsy showed metastatic disease in 20 patients

  • In the 39 other patients, no false-negative SLN were found.

Discussion

In this study, sentinel lymph node biopsy was highly accurate in predicting metastasis of early-stage vulvar cancer. Because of the high surgical complication rate of groin dissection in vulvar carcinoma, it would be extremely useful to have a reliable surrogate for the status of the lymph node to discover patients who have negative or only micrometastatic nodes and do not require a groin dissection. This report highlights the significant advantages that can be achieved using sentinel node biopsy in a variety of cancers.