Long term outcomes in patients with sentinel lymph nodes (SLNs) identified by injecting remaining scar after previously excised vulvar cancer

Nica, Andra; Covens, Allan; Vicus, Danielle; Kupets, Rachel; Gien, Lilian T.

doi:10.1016/j.ygyno.2019.08.015

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…More recently, Nica et al reported only one groin recurrence in 24 patients (4%) who underwent scar injections for vulvar cancer staging after a median follow-up of 31 months. The recurrence was observed in a patient with a nodal metastasis; they observed no recurrences in patients with negative sentinel lymph node biopsy 16. These consistent reports suggest that the hypothetical concern of lymphatic channel disruption resulting from previous vulvar excision does not appear to compromise sentinel lymph node biopsy accuracy.…”

Section: Discussionsupporting

confidence: 59%

Inguinofemoral sentinel lymph node biopsy by scar injection in vulvar cancer: an assessment of feasibility and long-term outcomes

Pascoal

Alyafi

Pokoradi

et al. 2022

Int J Gynecol Cancer

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BackgroundPerforming inguinofemoral sentinel lymph node biopsy for vulvar cancer following a previous vulvar excision, often referred to as ‘scar injection’, is debated.ObjectiveTo assess the feasibility of sentinel lymph node biopsy following scar injection and the long-term outcomes in patients undergoing this procedure.MethodsWe conducted a retrospective observational cohort study of patients with vulvar cancer. We assessed detection rates and outcomes in patients who underwent sentinel lymph node biopsy by scar injection and compared them with patients who had injection around a visible tumor and with patients who had an inguinofemoral lymphadenectomy following previous vulvar excision. Sentinel node detection rates are described per patient and per groin and are compared using Χ2analysis. Cox regression analysis was used to assess the association of recurrence and survival with surgical technique and recognized pathological variables.ResultsData were analyzed for 173 groins in 97 patients. At least one sentinel lymph node was detected in 162 (94%) groins examined, and detection rate did not differ whether the groin was assessed following tumor injection (n=122, 94%) or scar injection (n=40, 93%; p=0.85). Patients in the scar-injection group had less frequent lymph node metastases (p<0.02), smaller tumors (p<0.001), and more superficial invasion (p<0.02). Median follow-up was 34.7 months (range 0–108). Scar injection was not independently associated with recurrence or death on multivariable analysis, and depth of invasion was the only independent predictor of disease recurrence (hazards ratio (HR)=1.14, p=0.03). Recurrence and survival were also comparable for patients who had a sentinel lymph node biopsy or inguinofemoral lymphadenectomy following previous vulvar excision (log rank p=0.30; p=0.67).ConclusionsSentinel lymph node biopsy by scar injection is feasible and demonstrates similar long-term outcomes in patients having scar or tumor injections, and in patients following previous tumor excision undergoing sentinel lymph node biopsy or lymphadenectomy.

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Section: Discussionsupporting

confidence: 59%

Inguinofemoral sentinel lymph node biopsy by scar injection in vulvar cancer: an assessment of feasibility and long-term outcomes

Pascoal

Alyafi

Pokoradi

et al. 2022

Int J Gynecol Cancer

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“…Therefore, sentinel lymph node biopsy through vulvar incision is more convenient, practical, and minimally invasive. Data from long-term follow-up research confirmed that in patients with early vulvar squamous cell carcinoma, SLNB did not show a higher recurrence rate or lower survival rate, and the tumor prognosis was not inferior to that of classic ILND ( 25 ). Due to the reduced complication rate found with the SLN technique in other types of gynecological cancers such as endometrial cancer ( 26 ), SLNB through vulvar incision maybe have good application prospects in the future in VEIL-V application.…”

Section: Discussionmentioning

confidence: 81%

Analysis of Short-Term Efficacy of Gasless Single-Port Laparoscopic Inguinal Lymphadenectomy Through Vulva Incision for Vulvar Cancer

et al. 2022

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ObjectiveTo investigate the feasibility and short-term efficacy of gasless single-port laparoscopic inguinal lymphadenectomy through vulva incision (VEIL-V).MethodsThe data of 9 patients diagnosed as vulvar squamous cell carcinoma who underwent single-port laparoscopic inguinal lymph node dissection through vulvectomy incision were retrospectively analyzed. And 13 patients who underwent laparoscopic inguinal lymph node dissection through lower abdominal subcutaneous approach as the control group (VEIL-H). The operation time, blood loss, numbers of unilateral lymph nodes, hospitalization time, and complications between the two groups were compared.ResultsThe operation time of VEIL-V was 56.11 ± 5.94 min, which were shorter than that of VEIL-H (74.62 ± 5.50 min; P = 0.013). Bleeding amount in the VEIL-H was 29.44 ± 2.56, which was significantly lower than that of the VEIL-H group (43.08 ± 4.14 ml; P = 0.021). In the two groups, the numbers of unilateral lymph nodes harvested were similar. The differences in the postoperative hospital stay, skin, and lymphatic complications were not statistically significant.ConclusionCompared with VEIL-H, gasless single-port laparoscopic inguinal lymphadenectomy through vulva incision reduces the difficulty of operation with shorter operation time, and less blood loss, which can be a safe and mini-invasive surgical approach.

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“…The feasibility and accuracy of delayed SLNB after previous surgical treatment has been widely investigated in humans with melanoma, genital tumors, and breast cancer [ 33 , 37 , 38 , 39 , 40 , 41 ]. Detection rates ranging from 85.5% to 100% are similar to those reported when concurrent tumor excision is performed and are comparable to the detection rate of 91.2% recorded in our sample population [ 33 , 37 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy Is Feasible in Dogs with Scars from Prior Local Excision of Solid Malignancies

Gariboldi

Stefanello

Nolff

et al. 2022

Animals

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Sentinel lymph node (SLN) biopsy is a well-established staging tool in canine oncology. This study aims to explore the feasibility of SLN biopsy in dogs with scars from prior excised solid malignancies that were referred for further tumor staging and/or adjuvant treatment options. Mapping was either performed using radiopharmaceutical, methylene blue, and/or near-infrared fluorescent (NIRF) imaging. Thirty-three dogs with 34 scars from prior excision of the mast cell tumor (MCT) (n = 29), soft tissue sarcoma (n = 2), oral melanoma (n = 1), subungual melanoma (n = 1), and mammary adenocarcinoma (n = 1) were retrospectively enrolled. Primary treatment consisted of curative intent/wide tumor excisions in 50.0% of dogs and marginal excision in the remaining 50.0%. The median time between tumor excision and SLN biopsy was 50 days (range 17–110 days). The procedure was successful in 31/34 scars, translating to a detection rate of 91.2%. The SLN did not correspond to the regional lymph node in 19/31 scars (61.3%). SLN metastases were histologically identified in 13/31 (41.9%) dogs, all of them affected by MCT. Based on our results, SLN biopsy using lymphoscintigraphy/methylene blue and/or NIRF is feasible in dogs presenting with scars from the prior surgical excision of solid tumors, and should be suggested for accurate nodal staging.

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Long term outcomes in patients with sentinel lymph nodes (SLNs) identified by injecting remaining scar after previously excised vulvar cancer

Cited by 7 publications

References 16 publications

Inguinofemoral sentinel lymph node biopsy by scar injection in vulvar cancer: an assessment of feasibility and long-term outcomes

Inguinofemoral sentinel lymph node biopsy by scar injection in vulvar cancer: an assessment of feasibility and long-term outcomes

Analysis of Short-Term Efficacy of Gasless Single-Port Laparoscopic Inguinal Lymphadenectomy Through Vulva Incision for Vulvar Cancer

Sentinel Lymph Node Biopsy Is Feasible in Dogs with Scars from Prior Local Excision of Solid Malignancies

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