The usefulness of sentinel lymph node detection in vulvar cancer - a short communication

The sentinel lymph node (SLN) biopsy is a solution for decreasing the extent of surgery with a significant reduction of the incidence of complications without influencing treatment results.

We performed the sentinel lymph node procedure in 24 women with vulvar cancer. In 14 cases, only the blue dye technique was applied, and in 10 cases (99m)Tc-labelled nanocolloid with blue dye was administered simultaneously. The extent of the surgery included radical vulvectomy in 23 patients and a wide local excision in 1 patient. In 15 patients unilateral inguinofemoral lymphadenectomy was performed and in 9 cases bilateral lymphadenectomy. The total number of operated groins was 39.

SLNs were detected in 34/39 of operated groins (87.2%). In 4 cases (16.6%) tumour metastases to the lymph nodes were found. In total, 10 metastatic lymph nodes were detected in 9 sentinel-nodes and in 1 non-sentinel node. In three patients the nodal metastases were found only in the sentinel nodes. In one patient the metastases were found in the contralateral groin in two SLNs. There were no false negative sentinel lymph nodes. With the sole use of blue dye, SLNs were found in 79.5% of groins. The additional administration of the radiocolloid improved SLN detection to 88.9% of groins.

The parallel use of the (⁹⁹m)Tc labelled radiocolloid and blue dye enables high sentinel node detection rates by adequately trained surgeons.