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Gynecol Oncol. 2014 Jun;133(3):416-20. doi: 10.1016/j.ygyno.2014.03.010. Epub 2014 Mar 11.

Long-term follow-up of vulvar cancer patients evaluated with sentinel lymph node biopsy alone.

Author information

1
Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA. Electronic address: krobison@wihri.org.
2
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of North Carolina at Chapel Hill, Campus Box 7572, Chapel Hill, NC 27599-7572, USA.
3
Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
4
Department of Pathology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.

Abstract

OBJECTIVE:

The objective of this study was to examine SLN evaluation alone in women with squamous cell carcinoma (SCC) of the vulva and evaluate the inguinal recurrence and complication rates.

METHODS:

An IRB approved prospective study enrolled patients with SCC of the vulva. Peritumoral injection of Tc-99 sulfur colloid and blue dye was used to identify SLNs intraoperatively. Patients with negative SLN for metastasis were followed clinically without further treatment. Patients with metastasis to a SLN underwent full groin node dissection followed by standard treatment protocols.

RESULTS:

A total of 73 women were enrolled onto protocol with 69 patients undergoing SLN dissection. Mean age was 66.9years (range: 29-91) with 47 stage I, 12 stage II, 9 stage III, 2 stage IV and 3 unstaged patients. SLN dissections were successful in 63 patients. Of the 111 groins evaluated with a SLN dissection 93% had a SLN identified with an average of 2 SLN per groin. There were 92 groins with negative SLN and 11 groins with positive SLN. 57 patients had negative SLN and underwent conservative management with the median follow-up of 58.3months. Three patients experienced groin recurrences (2 unilateral, 1 bilateral) for a recurrence rate of 5.2% (3/57). The complication rate for the inguinal incisions was 17.5% (1 cellulitis, 1 abscess, 2 lymphoceles, 5 lymphedema and leg pain).

CONCLUSIONS:

Isolated SLN dissection alone has a low inguinal recurrence rate with decreased complications and should be considered as an option for women with SCC of the vulva.

KEYWORDS:

Complications; Inguinal recurrence rates; Sentinel lymph node biopsy; Vulvar cancer

PMID:
24631445
DOI:
10.1016/j.ygyno.2014.03.010
[Indexed for MEDLINE]
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