Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva

Hullu, Joanne de; Hollema, Harmen; Piers, Da; Verheijen, R; Diest, PJ van; Mourits, Marian J.E.; Aalders, Jan G.; Zee, van der Ate

doi:10.1200/jco.2000.18.15.2811

Cited by 316 publications

(163 citation statements)

References 19 publications

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“…31 Moreover, the sentinel lymph node procedure seems to be a good diagnostic tool with which to select patients for whom it is safe to omit complete inguinofemoral lymphadenectomy. 32 In both groups, all nonlocal recurrences were diagnosed within 2 years; whereas, after 2 years, only local recurrences were observed. The risk of local recurrence was increased in patients who had tumor free margins measuring Յ 8 mm.…”

Section: Discussionmentioning

confidence: 89%

Vulvar carcinoma

Hullu

Hollema²,

Lolkema³

et al. 2002

Cancer

249

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BACKGROUNDThe objective of this study was to determine whether modifications in the treatment of patients with vulvar carcinoma influence the rates of recurrence and survival.METHODSBetween 1982 and 1997, 253 patients with T1 and T2 invasive squamous cell carcinoma of the vulva were treated by essentially the same team of gynecologic oncologists, and 168 patients (Group I) underwent radical vulvectomy with en bloc inguinofemoral lymphadenectomy. Standard therapy was changed in 1993, and 85 patients (Group II) underwent wide local excision with inguinofemoral lymphadenectomy through separate incisions. The rates of recurrence and survival were compared between both groups.RESULTSIn Group II, the overall recurrence rate (33.3%) within 4 years was increased compared with Group I (19.9%; P = 0.03). In Group II, 5 of 79 patients (6.3%) developed fatal groin or skin bridge recurrences compared with 2 of 159 patients (1.3%) in Group I (P = 0.029); this did not result in a difference in overall survival. In Group II, 40 of 79 patients had tumor free margins measuring ≤ 8 mm, resulting in 9 local recurrences; whereas 39 of 79 patients had tumor free margins measuring > 8 mm, resulting in no local recurrences (P = 0.002).CONCLUSIONSThe current study showed that fatal recurrences in either the groin or the skin bridge were more frequent after wide local excision and inguinofemoral lymphadenectomy through separate incisions; however, probably due to lack of power, this did not result in shorter survival. In 40 of 79 patients, the histologic margins measured ≤ 8 mm, resulting in a high risk of local recurrences. Therefore, the authors recommend obtaining surgical margins of 2 cm for the local treatment of patients with vulvar carcinoma. Cancer 2002;95:2331–8. © 2002 American Cancer Society.DOI 10.1002/cncr.10969

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Section: Discussionmentioning

confidence: 89%

Vulvar carcinoma

Hullu

Hollema²,

Lolkema³

et al. 2002

Cancer

249

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“…66 Since then, several studies appear to have validated the sentinel lymph node concept in patients with vulvar cancer. [67][68][69] The number of cases examined still is small. A large validation trial is underway in North America under the auspices of the GOG.…”

Section: Lymphatic Mappingmentioning

confidence: 99%

Imaging in cervical cancer

Follen

Levenback

Iyer

et al. 2003

Cancer

125

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“…In the other 65-75% this intervention will (in retrospect) probably be only diagnostic. In order to reduce morbidity the sentinel lymph node (SLN) procedure was introduced in vulvar cancer treatment with promising results in different accuracy-studies [3][4][5][6][7][8][9][10]. Its safety has recently been shown in the Groningen International Study on Sentinel Nodes in Vulvar cancer (GROINSS-V) with a false negative rate of 2.8% in patients with unifocal early stage disease [11].…”

Section: Introductionmentioning

confidence: 99%

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Oonk

Bock

et al. 2009

Gynecologic Oncology

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A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy Oonk, M. H. M.; van Os, M. A.; de Bock, G. H.; de Hullu, J. A.; Ansink, A. C.; van der Zee, A. G. J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Objectives. The SLN-procedure has been introduced in vulvar cancer treatment to reduce morbidity and thereby improve quality of life. Aim of this study was to compare quality of life in vulvar cancer patients who were treated with a SLN-procedure only to those who underwent inguinofemoral lymphadenectomy. Moreover, it was evaluated what patients would advise relatives on the application of the SLN-procedure in light of possible false negative results.Methods. Patients who participated in the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) were invited to fill out three questionnaires: the EORTC QLQ-C30, a vulvar specific questionnaire and a questionnaire about the opinion of patients on new treatment options. Patients who only underwent SLN-procedure were compared to those who subsequently underwent inguinofemoral lymphadenectomy because of a positive SLN.Results. With a response rate of 85%, 35 patients after the SLN-procedure and 27 patients after inguinofemoral lymphadenectomy filled out the questionnaires. No difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of lymphedema of the legs after inguinofemoral lymphadenectomy. The majority of patients would advise the SLN-procedure to relatives. Patients after inguinofemoral lymphadenectomy were more reserved concerning the acceptable false negative rate of a new diagnostic procedure.Conclusions. Patients who underwent the SLN-procedure report less treatment related morbidity compared to those who underwent inguinofemoral lymphadenectomy. However, this did not influence overall quality of life. Furthermore, patients who underwent inguinofemoral lymphadenectomy are more reserved in advising the SLN-procedure to relatives.

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Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva

Cited by 316 publications

References 19 publications

Vulvar carcinoma

Vulvar carcinoma

Imaging in cervical cancer

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

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