Sentinel node and vulvar cancer: a series of 47 patients

Nyberg, Reita; Iivonen, Marjo; Parkkinen, Jyrki; Kuoppala, Tapio; Mäenpää, Johanna

doi:10.1080/00016340701286793

Cited by 26 publications

(16 citation statements)

References 10 publications

(19 reference statements)

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“…Many authors have reported the use of a combination of technetium and blue dye for the SLNB procedure in vulvar CA [25,[32][33][34][35][36][37][38][39][40][41][42]. Rationale behind this practice relates to the importance of identifying the SLNs intra operatively.…”

Section: Slnb Techniquementioning

confidence: 99%

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

McGee

Covens

2009

Womens Health (Lond Engl)

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Treatment for early-stage vulvar carcinoma has evolved from radical en bloc dissection to wide local incision with lymphadenectomy through separate groin incisions, to sentinel lymph node biopsy (SLNB). The morbidity of SLNB is far less than traditional inguinofemoral lymphadenectomy, with less lymphedema and sensory deficit, shorter hospital stays and fewer infections. A multidisciplinary approach is required, with success of the SLNB technique maximized when radiolabeled colloid is used, with blue dye added when further identification is needed. Frozen-section analysis, followed by ultrastaging of the nodal sample, minimizes the need for reoperations and decreases the risk of false negatives. We believe that SLNB will become the standard of care for treatment of early-stage vulvar carcinoma.

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Section: Slnb Techniquementioning

confidence: 99%

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

McGee

Covens

2009

Womens Health (Lond Engl)

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“…Under a 4.5-year familiarization period, a SLN mapping had been performed to all surgically treated vulvar cancer patients, and has been described elsewhere [17]. The specimens were obtained from the Tissue Biobank and Research Services FinTiB (Fimlab Laboratories Inc., Tampere, Finland).…”

Section: Patients and Tissue Samplesmentioning

confidence: 99%

Can vascular endothelial growth factor C expression be of use in predicting surgical stage or prognosis in vulvar cancer ?

Nyberg¹,

Laurila²,

Staff³

et al. 2017

J Cancer Res Ther.

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Introduction: Nodal metastasis is a main prognostic factor in vulvar cancer. Increased vascular endothelial growth factor C (VEGF-C) expression has been associated with lymph node metastasis and poor prognosis in many cancers. The aim of this retrospective study was to investigate VEGF-C expression pattern in the invasive edge of vulvar cancer and in sentinel lymph node metastasis, and its association with the stage and prognosis. Methods: Tumor and sentinel lymph node samples from 44 patients were evaluated with immunohistochemistry, and the results were linked with the clinicopathological data. Results: Sixty-seven percent of primary tumors and 76% of sentinel lymph node metastases expressed VEFG-C. Positive VEGF-C expression of the primary tumor did not predict surgical Stage or sentinel lymph node involvement. The risk of relapse was not significantly higher with VEGF-C expressing tumors than with VEGF-C negative tumors (RR 2.55, 95% CI 0.66-9.90, p = 0.18). The risk of groin recurrence was significantly lower with VEGF-C positive than negative tumors (RR 0.36, 95% CI 0.16-0.79, p = 0.01). Survival was similar in both groups. No non-sentinel lymph node metastases were found in case of negative VEGF-C expression in the sentinel lymph node metastasis, whereas with positive VEGF-C expression they were found in 5/13 (38%) of cases. Conclusions: Tumoral VEGF-C expression was not associated with higher surgical Stage or poorer prognosis in vulvar cancer. However, absence of its expression in sentinel lymph node metastasis might indicate a low risk for non-sentinel lymph node metastases.

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“…Studies in vulvar cancer in which SLN detection was followed by a completion inguinofemoral lymphadenectomy suggest that the SLN procedure is highly accurate in identifying lymph node metastases with an NPV approaching 100% [24,25,29,30,38,40,[65][66][67][68][69][70][71][72][73]. Table 1 illustrates selected studies on this subject.…”

Section: Squamous Cell Vulvar Carcinomamentioning

confidence: 99%

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

et al. 2009

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The treatment of gynecologic malignancies can include surgery, systemic therapy, and radiation. Depending on the primary site of disease and the extent of the disease, these treatment strategies are applied alone or in combination.Trends over the past few decades have concentrated on performing more comprehensive staging procedures for a large percentage of patients with gynecologic malignancies. The surgical techniques available for comprehensive staging have facilitated a greater understanding of stage and prognosis overall, and better tailoring of postsurgical treatment.One such technique is regional lymphadenectomy. Although the role of regional lymphadenectomy as a therapeutic procedure in some gynecologic cancers is debated and challenged (regional lymphadenectomy and multimodality therapy increases adverse side effects and long-term sequelae without proven survival benefit), there is no controversy regarding the staging and prognostic benefit of the evaluation of regional lymph nodes. The sentinel lymph node (SLN) concept was successfully introduced in melanoma. It has since become the standard of care in breast cancer and has had a significant impact on postoperative morbidity for a large percentage of breast cancer patients. Interest in using SLN techniques in gynecologic cancers was thus a natural progression. In light of the growing body of evidence in the literature opposing the therapeutic benefit of systematic lymphadenectomy, the SLN concept will continue to play an important role in the treatment of gynecologic malignancies. This technique can provide accurate staging information in some gynecologic cancers. Increased use of this technique could potentially impact the quality of life of gynecologic cancer survivors while still providing important staging information without compromising oncologic safety.In this review, we examine the body of literature related to gynecologic cancer malignancies and SLN biopsy. The Oncologist 2009;14:695-705

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Sentinel node and vulvar cancer: a series of 47 patients

Abstract: A sentinel node identification rate of 98% with a false-negative rate of 0% in the patients with Stage I-II disease is an encouraging finding.

Cited by 26 publications

References 10 publications

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

State of the Art of Sentinel Lymph Node Biopsy in Vulvar Carcinoma

Can vascular endothelial growth factor C expression be of use in predicting surgical stage or prognosis in vulvar cancer ?

Sentinel Lymph Node Biopsy in the Management of Vulvar Carcinoma, Cervical Cancer, and Endometrial Cancer

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