Editorial

Sentinel node assessment for diagnosis of groin lymph node involvement in vulval cancer

“…Primary vulval lesions are treated by wide local excision (WLE). Lesions smaller than 2 cm, with a depth of invasion less than 1 mm (FIGO stage IA), do not require removal of lymph nodes (inguinofemoral lymphadenectomy; IFL) from the groin due to the extremely low risk (less than 1%) of metastasis (Hacker 1993). However, in all other cases (FIGO stage IB and higher) removal of all groin lymph nodes (IFL) has been the traditional gold standard of treatment.…”

“…However, in all other cases (FIGO stage IB and higher) removal of all groin lymph nodes (IFL) has been the traditional gold standard of treatment. Vulval tumours away from midline (lateralised) require removal of groin lymph nodes from the same side, whilst midline tumours require removal of lymph nodes from both sides (Hacker 1993;Iversen 1981). Most women with positive groin lymph nodes will require further treatment with radiation a er surgery, with its risk of additional morbidity.…”

“…Surgical excision of tumour and lymphatic staging remains a cornerstone of the management in vulval cancer. For very earlystage disease (FIGO IA), WLE without lymphatic staging is an accepted method of treatment due to the low risk (less than 1%) of lymph node metastasis (Hacker 1993). For FIGO stage IB disease or above, a WLE of vulval tumour along with the removal of groin lymph nodes from one or both sides (depending on the tumour location) is the traditional treatment of choice (Hacker 1993;Iversen 1981).…”

“…For very earlystage disease (FIGO IA), WLE without lymphatic staging is an accepted method of treatment due to the low risk (less than 1%) of lymph node metastasis (Hacker 1993). For FIGO stage IB disease or above, a WLE of vulval tumour along with the removal of groin lymph nodes from one or both sides (depending on the tumour location) is the traditional treatment of choice (Hacker 1993;Iversen 1981). This treatment, however, is associated with significant morbidity related to wound and lymph drainage in up to 70% of cases (Gaarenstroom 2003;Rouzier 2003;Stehman 1992; Van der Zee 2008).…”