Outcomes for patients with T1 squamous cell cancer of the vulva undergoing sentinel node biopsy

Terada, Keith Y.; Shimizu, David; Jiang, Caroline S.; Wong, Jan H.

doi:10.1016/j.ygyno.2005.11.042

Cited by 48 publications

(31 citation statements)

References 14 publications

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“…However, there are several retrospective studies for oncological safety indicating that there is no difference in oncological outcome between SLNB and ILND [14,20,25,26]. Johann, et al [14] compared the outcome between 16 patients with pN0 pT1/2 after SLNB and 18 patients with ILND [14].…”

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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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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“…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%

“…There were four studies 50,65,70,73 in which, if the SLN was found to be negative, no IFL was performed but patients were followed up clinically instead. In a study by Van den Eynden et al, 72 10 out of 32 patients had a SLN biopsy plus full IFL.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…Additionally, a study by Levenback et al 61 mentioned that, in one patient in whom SLN was grossly positive after SLN biopsy, the surgeon aborted IFL in favour of RT. Adverse events (AEs) were reported in five studies 54,65,70,72,73 (see Appendix 10, Table 55). …”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…In group 2 are Achimas-Cadariu et al, 50 Moore et al, 65 Terada et al, 70 Van den Eynden et al 72 and Van der Zee et al 73 The overall recurrence rates are given in Tables 12 and 22. Achimas-Cadariu et al…”

Section: Recurrence Ratesmentioning

confidence: 99%

See 2 more Smart Citations

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

Lawrie

Patel

Martin-Hirsch

et al. 2014

Cochrane Database of Systematic Reviews

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Traceable agents for sentinel lymph node assessment in vulval cancer Review question: how does the diagnostic test accuracy of various techniques using traceable agents for sentinel lymph node assessment in vulval cancer compare? Patients or population: women with FIGO stage IB or higher vulval cancer without palpable/suspicious groin nodes Settings: tertiary level hospitals Role: to diagnose groin lymph node metastases Index tests: blue dye, technetium, combined tests (blue dye and technetium) and mixed tests (blue dye, technetium or combined tests) Reference standard: histological examination following complete inguinofemoral lymphadenectomy Studies: prospective (30) and retrospective (4) cohort Consequences in a cohort of 100 women undergoing SN assessment, assuming the prevalence of groin metastases to be 30% Index test Quantity of evidence Mean detection rate* Cochrane Library Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews Sentinel node assessment for diagnosis of groin lymph node involvement in vulval cancer (Review)

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Outcomes for patients with T1 squamous cell cancer of the vulva undergoing sentinel node biopsy

Cited by 48 publications

References 14 publications

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

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

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

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

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