Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma

Brincat, Mark; Baron, Yves Muscat

doi:10.1097/igc.0000000000001075

Cited by 27 publications

(22 citation statements)

References 44 publications

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“…The obtained findings are consistent with those of De Cicco et al and Sliutz et al, who reported a 100% detection rate using Technetium-99-m-labeled nanocolloid, with or without blue dye [11,12]. Additionally a meta-analysis performed by Brincat et al confirmed the safety and feasibility of SLN biopsy in vulvar cancer [13].…”

Section: Discussionsupporting

confidence: 89%

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis

Piechowicz¹,

Mikoś²,

Banaś³

et al. 2020

Ann Agric Environ Med.

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Introduction and objective. Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. Materials and method. Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. Results. Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). Conclusions. SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.

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Section: Discussionsupporting

confidence: 89%

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis

Piechowicz¹,

Mikoś²,

Banaś³

et al. 2020

Ann Agric Environ Med.

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“…Currently, there are corresponding recommendations for patients who are eligible for SLNB. Patients with tumors that are unifocal, less than <4 cm in diameter, and with no evidence of lymph node involvement by preoperative assessment, are eligible for SLNB 35 , while patients with multifocal disease, clinically suspicious groin nodes, or a tumor located in the midline are unsuitable 13 , 14 , 24 . In addition, patients who have undergone preoperative radiotherapy/chemotherapy should probably be excluded because damage to the lymph vessels may affect the SLNB procedure 36 .…”

Section: Discussionmentioning

confidence: 99%

Trends and Outcomes of Sentinel Lymph Node Biopsy in Early-stage Vulvar Squamous Cell Carcinoma: A Population-based Study

Zhou¹,

Zhang²,

Wu³

et al. 2018

J. Cancer

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Purpose: To compare trends and outcomes between lymphadenectomy and sentinel lymph node biopsy (SLNB) in node-negative early-stage vulvar squamous cell carcinoma (SCC) using a population-based cancer registry.Methods: Patients with vulvar SCC registered on the Surveillance, Epidemiology, and End Results program between 2003 and 2013 were identified. Statistical analysis was performed using Cox regression proportional hazards to calculate hazard ratio (HR) and 95% confidence interval (CI). A 1:1 propensity score matching (PSM) method was performed to minimize selection bias.Results: A total of 1475 patients were identified, including 1346 (91.3%) who received lymphadenectomy and 129 (8.7%) who underwent SLNB. The proportion of patients receiving SLNB increased between 2008 and 2013 compared with the years 2003-2007 (13.9% vs. 3.7%, p < 0.001). Five-year cause-specific survival (CSS) in patients who received lymphadenectomy and SLNB was 91.8% and 92.9%, respectively (p = 0.912), and 5-year overall survival (OS) was 77.5% and 82.5%, respectively (p = 0.403). SLNB was not associated with an decrease in CSS (HR 1.024, 95% CI 0.474-2.213, p = 0.952) or OS (HR 0.874, 95% CI 0.541-1.410, p = 0.581) in univariate and multivariate analyses. A total of 115 pairs were selected by PSM and survival analysis also showed comparable CSS (p = 0.481) and OS (p = 0.545) between lymphadenectomy and SLNB.Conclusions: There is an increasing trend toward SLNB in the treatment of patients with node-negative early-stage vulvar SCC, and survival is comparable between lymphadenectomy and SLNB.

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“…Histological examination of the sentinel lymph node is representative for all other lymph nodes in the area, and histologically, a negative sentinel lymph node means the absence of metastases in subsequent lymph nodes. [16][17][18][19] The sentinel lymph node is marked in two ways, with a nanocolloid bound to 99mTc (Technetium) and with a patent blue. This method is the most reliable, as the sentinel lymph node is found in 97.7% of cases.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Modern treatment of vulvar cancer

Merlo

2020

Radiology and Oncology

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BackgroundVulvar cancer accounts for 3–5% of malignant diseases of the female genital tract. The Slovenian incidence rate is 5.5/100,000, which means 57 new cases per year. The most common histological type (90%) is squamous cell carcinoma. Based on etiology, it can be classified into the first type which correlates with human papillomavirus (HPV) infection and the second type which is not associated with HPV. The most common and long-lasting symptom of vulvar cancer is pruritus. The preferred diagnostic procedure to confirm the diagnosis is a punch or incision biopsy. Surgery in combination with radiotherapy is the standard treatment for vulvar cancer. Sentinel lymph node biopsy with lymphoscintigraphy is now a standard part of surgical treatment. Chemotherapy is a palliative treatment option.ConclusionsVulvar cancer is a rare disease. Because of the pathogenesis, surgery and radiotherapy are the main treatment modalities. The sentinel node biopsy (SNB) represents a contemporary approach to the vulvar cancer treatment and significantly reduces morbidity. Improvements in treatment of vulvar cancer contributed to the decrease of mortality among Slovenian women.

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Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma

Cited by 27 publications

References 44 publications

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis

Trends and Outcomes of Sentinel Lymph Node Biopsy in Early-stage Vulvar Squamous Cell Carcinoma: A Population-based Study

Modern treatment of vulvar cancer

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