IMR Press / EJGO / Volume 39 / Issue 1 / DOI: 10.12892/ejgo3656.2018
Open Access Original Research
Sentinel lymph node biopsy in vulvar cancer: a multicenter evaluation of procedure’s feasibility for Israeli patients
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1 Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2 Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel, Affiliated to the Hebrew University “Hadassah” Medical School, Jerusalem, Israel
3 Department of Obstetrics and Gynecology, Soroka Medical Center, Affiliated to Ben Gurion University of the Negev, Beer Sheva, Israel
4 Radio Guided Surgery Unit, Department of Surgery, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
† Contributed equally.
Eur. J. Gynaecol. Oncol. 2018 , 39(1), 14–18; https://doi.org/10.12892/ejgo3656.2018
Published: 10 February 2018
Abstract

Purpose: To evaluate the accuracy, safety, and outcome of sentinel lymph node biopsy (SLNB) in early-stage vulvar cancer and determine the applicability of this procedure for selected patients in Israel. Materials and Methods: Forty-five patients with T1 squamous cell carcinoma (SCC) of the vulva who underwent surgery with SLNB between 2002-2011 were included. SLN was detected using both radioactive tracer and blue dye. All resected nodes underwent pathological examination. The accuracy, recurrence rates, and complications of the procedure were analyzed. Results: There was a significant correlation between radioactive reading intensity and SLN detection in frozen section (p < 0.0003, p < 0.0001). A weaker correlation existed with use of blue dye (p = 0.04, p = 0.09). For metastatic LNs, the detection rates of both agents were similar. The false negative for metastatic SLN detection in frozen section was 12.5%, while the false positive was 2%. The rate of inguinal recurrence without local recurrence was 4.4%. For patients with unifocal vulvar disease and a negative sentinel node the seven-year survival rate was 94%. Conclusion: SLNB is an effective and safe procedure for Israeli patients with earlystage SCC of the vulva. Recurrence rates and disease-free survival are similar to the reported literature and morbidity is low compared to radical inguinal LNs resection.
Keywords
Vulva
Carcinoma
Sentinel lymph node biopsy
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