A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Oonk, Maaike H. M.; Os, Moore; Bock, de Truuske; Hullu, Joanne A. de; Ansink, Anca C.; Zee, van der Ate

doi:10.1016/j.ygyno.2008.12.006

Cited by 89 publications

(81 citation statements)

References 32 publications

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“…Furthermore, the only study to measure global health status (QoL) 82 showed no difference for patients who received the different procedures that are considered in this analysis. Therefore, the option of using the quality-adjusted life-year (QALY) as an outcome measure was not available in this economic evaluation.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Meads¹,

Sutton²,

Małysiak³

et al. 2013

Health Technology Assessment

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Section: Discussionmentioning

confidence: 97%

“…The most useful result was the global health status/QoL, which had a mean of 80 and a standard deviation (SD) of 18 for the SLN group and a mean of 82 It may be that there were too few participants to detect a small difference in QoL.…”

Section: Quality Of Lifementioning

confidence: 99%

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Meads¹,

Sutton²,

Małysiak³

et al. 2013

Health Technology Assessment

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“…However, despite the clear clinical benefit, surgeons have not yet widely adopted this concept as standard of care, in early vulvar cancer [22]. Contrary to a study comparing quality of life between vulvar cancer patients after SLNB only and ILND showed that the majority of patients with SLNB are more content with their overall status and would advise the SLNB-procedure to relatives [23]. Another study reported that most women would choose complete ILND over SLNB, preferring the -'assumed' -higher safety of ILND over improved quality of life [24].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Outcome after Sentinel Lymph Node Biopsy or Inguinal Lymph Node Dissection in Patients with Nodal Negative Squamous Vulvar Cancer

Ebner¹,

Antje²,

Schramm³

et al. 2017

Glob Surg

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Sentinel lymph node biopsy (SLNB) can reduce postoperative morbidity in women with vulvar cancer but data on long-term outcome of SLNB compared to inguinal lymph node dissection (ILND) is rare. Recurrence rates, disease-free survival (DFS) and overall survival (OS) from pT1/T2 pN0 squamous vulvar cancer from 1992 -2011 were retrospectively compared between patients with SLNB (n=56) or ILND (n=56). PT2 tumors (59% vs. 11%; p<0.001) and complete vulvectomy (39% vs. 4%; p < 0.001) occured more often in the ILND than the SLNB group with no difference in lymph node recurrence rate. Multivariate survival analysis considering the year of primary diagnosis, tumor stage and surgery revealed no significant effect of treatment on DFS (p=0.062) or OS (p=0.924). SLNB seems to be a safe treatment for women with pT1/T2 nodal-negative vulvar cancer with no difference in DFS or OS compared to ILND. Those results confirm the results of the GROINSS-V Study and other literature with the longest follow-up data reported within a real-life collective. Impact statementSLNB has been shown to reduce postoperative morbidity in women with vulvar cancer, however, data on long-term outcome of SLNB in vulvar cancer is rare. The aim of this study was to evaluate the outcome of patients with nodal-negative vulvar cancer that had undergone either SLNB or ILND in a clinical collective. Patients in the ILND group presented with more pT2 tumors (59% vs. 11%; p< 0.001) and followed by complete vulvectomy (39% vs. 4%; p <0.001). The lymph node recurrence rate was not significantly different between both groups (p=0.57). A multivariate survival analysis accounting for year of primary diagnosis, tumor stage and type of surgery revealed no significant effect of treatment on DFS or OS. SLNB seems to be a safe treatment for women with T1/T2 nodal-negative vulvar cancer, as we observed no difference in DFS or OS compared to patients with ILND. However, because of the observed bias between the two groups, results have to be interpreted carefully and need to be confirmed in larger prospective trials. Nevertheless, the results represent further data regarding the oncological safety of SNB supporting current literature and strongly underlie its value in the described setting with the longest follow-up, to date, reported.

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“…However, less postoperative morbidity did not translate into an improved QoL score. 16 Regarding the oncological safety of the SLN procedure, the data provided by a large German multicenter observational study on the accuracy and safety of SLN detection in early vulvar cancer, indicates that it appears safe to omit further lymph node dissection in case of a negative SLN from the groin. 11 However, the SLN technique in SCC contains many nonstandardized variables.…”

Section: Contextmentioning

confidence: 99%

“…These results are in concordance with those of other authors who were able to demonstrate that a preoperative lymphoscintigraphy did not enhance the detection rate of the SLN as compared to an intraoperative identification using a handheld probe only. 16 Since the mortality from local relapse in the groin is high and the decision for adjuvant therapy in vulvar cancer is exclusively based on lymph node status, the determination of the lymph node status has to be highly accurate and errors are fatal and not acceptable. Successful…”

Section: Sln Mapping In Vulvar Cancer Patientsmentioning

confidence: 99%

Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intra-operative mapping with technetium-99m-labeled nanocolloid

Klar

Bossart

Stickeler

et al. 2011

European Journal of Surgical Oncology (EJSO)

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To cite this version:M. Klar, M. Bossart, E. Stickeler, I. Brink, M. Orlowska-Volk, et al.. Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intraoperative mapping with technetium-99m-labeled nanocolloid. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (9) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT Key words /MeSH terms:Vulvar carcinoma, sentinel lymph node, technetium-99m nanocolloid Conflict of interestThe authors declare no conflict of interest M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 Abstract Aims:Sentinel lymph node (SLN) mapping appears to be feasible in patients with primary vulvar cancer. Previous protocols describe the injection of the technetium-99m-nanocolloid at least 3 hours before surgery which involves two invasive procedures for the patient. In this study, we assessed the feasibility, safety, and accuracy of an intraoperative rather than preoperative SLN mapping in patients with primary vulvar cancer. Methods:Patients with histologically confirmed squamous cell vulvar cancer and clinically FIGO stage Ib disease underwent intraoperative SLN mapping by intradermal injection of the nanocolloid around the tumor. SLN were identified and removed before a complete inguino-femoral lymphnode dissection was performed. Surgical and pathologic data on all patients were prospectively entered into a database. Results:A SLN procedure was performed in 16 patients; 3 patients received unilateral lymphadenectomy, and 13 women underwent surgery on both groins. In all groins but 4 at least one SLN was clearly identified (detection rate 25/29, 86%). A median number of 2 SLN and 4 non-SLN per groin were removed. 3 of 16 patients (19 %) had metastatic disease in the lymph nodes. There was no false negative SLN result. Conclusion:Intraoperative SLN detection seems feasible in patients with early stage vulvar cancer. More patients need to be enrolled in this ongoing study before this more convenient technique can be considered safe.

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A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Cited by 89 publications

References 32 publications

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation

Comparison of Outcome after Sentinel Lymph Node Biopsy or Inguinal Lymph Node Dissection in Patients with Nodal Negative Squamous Vulvar Cancer

Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intra-operative mapping with technetium-99m-labeled nanocolloid

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