Comparison of recurrence after vulvectomy and lymphadenectomy with and without sentinel node biopsy in early stage vulvar cancer

Martínez-Palones, José M.; Pérez-Benavente, María A.; Gil‐Moreno, Antonio; Díaz-Feijoó, Berta; Roca, Isabel; García-Jiménez, Ángel; Aguilar-Martínez, Ignacio; Xercavins, Jordi

doi:10.1016/j.ygyno.2006.05.024

Cited by 37 publications

(33 citation statements)

References 35 publications

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“…This rate was also comparable with the rates (18.8% to 26.2%) in the other series. 5,6 The incidence of groin recurrence was 10.6% in the current study and similar to the rate of 10.1% groin recurrence in a study of 158 patients who were treated with bilateral lymphadenectomy by Baiocchi et al…”

Section: Discussionsupporting

confidence: 90%

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

Cırık¹

2016

UHOD

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We aimed to determine the prognostic significance of tumor and lymph node (LN) characteristics on disease free survival (DFS) in patients who underwent surgery for squamous cell vulvar carcinoma. A total of 94 patients who underwent vulvar surgery and groin dissection were included. The impact of clinicopathologic variables such as age, body mass index, tumor size, tumor depth, total and metastatic lymph node number on DFS were assessed. The estimates of survival were determined with Kaplan-Meier and log rank analysis. In the univariate analysis; age, body mass index, tumor size, tumor location, total LN number, metastatic LN number and adjuvant therapy did not have impact on DFS. The median number of removed LNs was 21. Although removal of higher number of lymph nodes did not improved the DFS, patients who had ≤ 3 metastatic LNs had better 2-year DFS rate compared to those with >3 metastatic LNs (71.8% vs 40.0%; p= 0.042, respectively). In the multivariate analysis, both the depth of tumor invasion and LN involvement were the independent predictors of DFS. Additionally, in stage III disease, patients receiving adjuvant therapy had significantly less locoregional recurrence compared to those who did not receive. The presence of LN metastasis and increased tumor depth (> 3 mm) are poor prognostic factors for DFS in squamous cell vulvar cancer. Although the number of lymph nodes removed was not correlated with DFS, patients who had ≤ 3 metastatic LNs had better DFS compared to those with > 3 LNs. Keywords: Vulvar cancer, lymph node, disease free survival, recurrence ÖZET Skuamöz Hücreli Vulva Kanserinde Tümör ve Lenf Nodu Özelliklerinin Hastalıksız Sağkalıma EtkisiBu çalışmada, skuamöz hücreli vulva kanseri için cerrahi yapılan hastalarda tümör ve lenf nodu (LN) özelliklerinin hastalıksız sağkalıma (DFS) etkisini incelemek amaçlandı. Vulvar cerrahi ve lenf nodu diseksiyonu yapılan toplam 94 hasta çalışmaya dahil edildi. Yaş, vücut kitle indeksi, tümör boyutu, tümör derinliği, total ve metastatik LN sayısı gibi klinikopatolojik değişkenlerin DFS'ye etkisi araştırıldı.Sağkalım analizleri ise Kaplan-Meier ve log rank analizi ile yapıldı. Univaryant analizine göre, yaş, vücut kitle indeksi, tümör boyutu ve yeri, toplam LN sayısı, metastatik LN sayısı ve adjuvan tedavi DFS üzerine etkili bulunmadı. Ortalama olarak 21 tane LN çıkarıldı. Ortalamadan fazla lenf nodu çıkarılması DFS üzerine etkili olmasa da, 3 ve daha az metastatik LN çıkarılan hastalar, 3'den fazla metastatik LN çıkarılanlardan daha iyi 2-yıllık-DFS'ye sahip bulundu (sırasıyla, %71.8 ve %40.0; p= 0.042). Multivaryant analizde, hem tümör derinliği hem de LN tutulumu DFS'nin bağımsız prediktörleri idi. Ek olarak, evre III hastalıkta, adjuvan tedavi alan hastalar almayanlara göre daha az lokal (perineal ve kasık) nüksüne sahip idi. Lenf nodu metastazı ve artmış tümör derinliği (> 3 mm), skuamöz hücreli vulva kanseri için kötü prognostic faktörlerdir. Çıkarılan LN sayısı ile 2-yıllık-DFS korele olmasa da evre III hastalarda, 3 ve daha az metastatik LN...

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Section: Discussionsupporting

confidence: 90%

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

Cırık¹

2016

UHOD

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“…In such cases, only the sensitivity and specificity results can be given for the combination of tests used rather than only blue dye or 99m Tc separately or only both used together in all patients. However, for the other 20 studies, 50,51,[53][54][55][56][57][58][59][60][61][63][64][65][68][69][70][71][72][73][74] detection rates per groin can be given for each test separately and both tests combined (see Table 7). It is noticeable that the histopathological techniques used for the full IFL specimens were either not given or were less detailed than those used for the SLNs.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The most commonly reported tumour type was SCC. Five studies included one or two melanomas 53,58,61,63,71 and seven included other tumour types. 39,57,61,66,71,72,74 Either TNM, FIGO or grade staging, alone or in combination, was given in all studies.…”

Section: Characteristics Of Included Studiesmentioning

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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“…Many authors have reported the use of a combination of technetium and blue dye for the SLNB procedure in vulvar CA [25,[32][33][34][35][36][37][38][39][40][41][42]. Rationale behind this practice relates to the importance of identifying the SLNs intra operatively.…”

Section: Slnb Techniquementioning

confidence: 99%

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

McGee

Covens

2009

Womens Health (Lond Engl)

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Treatment for early-stage vulvar carcinoma has evolved from radical en bloc dissection to wide local incision with lymphadenectomy through separate groin incisions, to sentinel lymph node biopsy (SLNB). The morbidity of SLNB is far less than traditional inguinofemoral lymphadenectomy, with less lymphedema and sensory deficit, shorter hospital stays and fewer infections. A multidisciplinary approach is required, with success of the SLNB technique maximized when radiolabeled colloid is used, with blue dye added when further identification is needed. Frozen-section analysis, followed by ultrastaging of the nodal sample, minimizes the need for reoperations and decreases the risk of false negatives. We believe that SLNB will become the standard of care for treatment of early-stage vulvar carcinoma.

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Comparison of recurrence after vulvectomy and lymphadenectomy with and without sentinel node biopsy in early stage vulvar cancer

Cited by 37 publications

References 35 publications

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

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

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

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