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Sentinel node biopsy in early vulvar cancer
C De Cicco1, M Sideri, M Bartolomei
1Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy.
British Journal of Cancer
|January 26, 2000
Summary
Sentinel node biopsy using lymphoscintigraphy and a gamma probe is a reliable method for detecting vulvar cancer metastasis. This technique accurately identifies positive nodes, potentially reducing the need for extensive groin dissection and its associated morbidity.
Area of Science:
- Oncology
- Surgical Oncology
- Nuclear Medicine
Background:
- Lymph node status is critical for vulvar cancer prognosis.
- Complete inguinofemoral lymph node dissection causes significant morbidity.
- Sentinel node biopsy is effective in melanoma and breast cancer.
Purpose of the Study:
- To assess the feasibility of identifying sentinel groin nodes in early vulvar cancer using lymphoscintigraphy and a gamma-detecting probe.
- To evaluate the reliability of this technique for detecting lymph node metastasis.
Main Methods:
- 37 patients with early vulvar cancer (T1-T2) received perilesional Technetium-99m-labelled colloid human albumin.
- Lymphoscintigraphy was performed preoperatively.
- An intraoperative gamma-detecting probe guided sentinel node identification followed by complete inguinofemoral lymph node dissection.
Main Results:
- Sentinel node localization was successful in all 55 dissected groins across 37 patients.
- Of 8 cases with positive nodes, the sentinel node was positive in all, and the only positive node in 5 cases.
- All 29 patients with negative sentinel nodes were free of lymph node metastases.
Conclusions:
- Lymphoscintigraphy combined with gamma-probe guided sentinel node biopsy is an easy and reliable method for early vulvar cancer.
- This technique offers a less aggressive surgical approach for vulvar cancer staging.