Groin sentinel node biopsy and 18F-FDG PET/CT-supported preoperative lymph node assessment in cN0 patients with vulvar cancer currently unfit for minimally invasive inguinal surgery: The GroSNaPET study

Garganese, Giorgia; Collarino, Angela; Fragomeni, Simona Maria; Rufini, Vittoria; Perotti, Germano; Gentileschi, Stefano; Evangelista, Maria Teresa; Ieria, Francesco Pio; Zagaria, Luca; Bove, Sonia; Giordano, Alessandro; Scambia, Giovanni

doi:10.1016/j.ejso.2017.06.018

Cited by 54 publications

(55 citation statements)

References 36 publications

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“…Actually, sentinel lymph node biopsy has become increasingly accepted as an alternative method to lymphadenectomy, especially in the management of patients with early‐stage vulvar cancer …”

Section: Discussionmentioning

confidence: 99%

“…The intraoperative evaluation of the sentinel lymph node, representing the first regional station that drains from the primary tumor, offers a high chance to define the negative or positive involvement of the entire regional lymph nodes. In this regard, intraoperative diagnosis would avoid unnecessary lymphadenectomies in patients with early‐stage vulvar cancer . Nonetheless, another useful diagnostic tool is represented by ultrasound combined with FNAC.…”

Section: Discussionmentioning

confidence: 99%

“…2,7,17 Actually, sentinel lymph node biopsy has become increasingly accepted as an alternative method to lymphadenectomy, especially in the management of patients with early-stage vulvar cancer. 8,9,18 The intraoperative evaluation of the sentinel lymph node, representing the first regional station that drains from the primary tumor, offers a high chance to define the negative or positive involvement of the entire regional lymph nodes. In this regard, intraoperative diagnosis would avoid unnecessary lymphadenectomies in patients with early-stage vulvar cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, diagnostic techniques such as clinical examination, computed tomography, and magnetic resonance imaging have demonstrated low specificity, so that most malignant criteria are still based on size . Actually, the most reliable technique to identify those patients who have lymph node metastases is represented by the sentinel lymph node biopsy procedure, which has become increasingly accepted in the management of vulvar cancer …”

Section: Introductionmentioning

confidence: 99%

“…7 Actually, the most reliable technique to identify those patients who have lymph node metastases is represented by the sentinel lymph node biopsy procedure, which has become increasingly accepted in the management of vulvar cancer. 8,9 It makes sense that a reliable tool in the evaluation of lymph nodes is represented by ultrasound combined with fine-needle aspiration cytology (FNAC). This technique has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, thyroid neoplasms, and breast, lung, and cervical carcinoma.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound‐guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: Results from a comparative cytohistological study

Angelico

Santoro

Inzani

et al. 2019

Cancer Cytopathology

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Background Lymph node metastases represent the most important negative prognostic predictor in vulvar carcinoma. Therefore, an accurate preoperative assessment of suspicious lymph nodes would be fundamental for a personalized therapy. The aim of this article was to assess the reliability of ultrasound‐guided fine‐needle aspiration cytology (FNAC) in the preoperative assessment of nodal metastatic disease in 43 patients with vulvar cancer. Methods In total, 43 FNAC specimens of clinicoradiologically suspicious lymph nodes with corresponding nodal resection specimens were collected from 2016 to 2018 at Catholic University Hospital in Rome. Cytohistologic correlation was performed. Patients were treated with wide local excision of the vulvar mass followed by bilateral inguinofemoral lymphadenectomy and radiotherapy if the tumor involved a lymph node or the vulvar margins. Results Cytologic examination agreed with histology in 37 of 43 cases (86.04%). The authors observed a positive FNAC result in 14 of 20 histologically confirmed metastatic lymph nodes, 6 false‐negative cases, and no false‐positive results. The sensitivity and specificity of cytological examination were 76.92% and 100%, respectively. All patients with FNAC‐positive results showed metastatic disease in other surgically resected inguinofemoral nodes. Eleven of 29 patients (37.9%) with FNAC‐negative results also showed metastatic disease in subsequent lymphadenectomy specimens, but the extent of metastases was always <1 cm (range, 0.1‐0.6 cm). Conclusions FNAC of suspicious lymph nodes represents a useful tool in the management of patients with vulvar cancer. A positive result enables the surgeon to immediately perform a bilateral inguinofemoral lymphadenectomy thus avoiding an unnecessary sentinel lymph node sampling. Finally, FNAC can also predict the presence and extent of metastatic disease in other surgically resected inguinofemoral lymph nodes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound‐guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: Results from a comparative cytohistological study

Angelico

Santoro

Inzani

et al. 2019

Cancer Cytopathology

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Imaging the Lymphatic System

Tartaglione¹,

Pagan²,

Ieria³

et al. 2023

Radiology‐Nuclear Medicine Diagnostic Imaging

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SPECT/CT and fusion ultrasound to target the efferent groin lymph node for lymphatic surgery

et al. 2019

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Introduction: Pelvic lymphadenectomy (PL) causes changes to the inguinal lymph nodes with progressive loss of immune and lymphatic pump function. Efferent lymphatic vessel-to-venous anastomosis (ELVA) has been reported to address this problem. The aim of this report was to describe the feasibility of the SPECT/CT combined with ultrasound fusion imaging (UFI) to target the groin efferent lymph node (GELN) for ELVA.Patients and Methods: Twelve patients with lower limb lymphedema after PL were scheduled for peripheric lymphaticovenular anastomosis (LVA) combined with ELVA.All-patients were clinically ISL-stage1, with good visualization of the inguinal lymph nodes at preoperative lymphoscintigraphy. The mean patient age was 55.4 years and the mean BMI was 25.5.The mean limb circumference (MLC) was calculated before surgery and 1 year after surgery. The LymQoL-Leg questionnaire was administered before surgery and 6 months after surgery. Before surgery, the GELN was identified by SPECT/CT and its location was marked on the skin by UFI virtual navigation. Peripheric LVA sites were planned by ultrasound and indocyanine green (ICG) lymphography. Pre and postoperative MLC and LymQoL-Leg scores were compared.Results: In all-patients, the SPECT/CT succeeded at detecting and targeting the GELN. In all-patients, real-time anatomical coregistration with US was feasible, and it was possible to mark on the groin skin the depth and position of the GELN on the skin at the groin. During surgery, in every patient, we found the GELN marked before surgery and performed ELVA. We also performed two or three peripheric LVAs in every patient. The mean value of MLC decreased (38.2 ± 2.13 cm vs. 36.33 ± 2.14 cm; p = .04) and the mean score of the LymQoL-Leg questionnaire improved (9.3 ± 1.7 vs. 7.7 ± 1.1; p = .02).Conclusion: SPECT/CT combined with UFI is feasible for the preoperative identification of GELN for ELVA.

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Groin sentinel node biopsy and 18F-FDG PET/CT-supported preoperative lymph node assessment in cN0 patients with vulvar cancer currently unfit for minimally invasive inguinal surgery: The GroSNaPET study

Cited by 54 publications

References 36 publications

Ultrasound‐guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: Results from a comparative cytohistological study

Ultrasound‐guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: Results from a comparative cytohistological study

Imaging the Lymphatic System

SPECT/CT and fusion ultrasound to target the efferent groin lymph node for lymphatic surgery

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