Sentinel Node Dissection Is Safe in the Treatment of Early-Stage Vulvar Cancer

Zee, Ate G.J. van der; Oonk, Maaike H. M.; Hullu, Joanne A. de; Ansink, Anca C.; Vergote, Ignace; Verheijen, René H.M.; Maggioni, Angelo; Gaarenstroom, Katja N.; Baldwin, Peter; Dorst, Eleonore B. Van; Velden, J. van der; Hermans, R; Putten, Hans van der; Drouin, P; Schneider, Achim; Sluiter, Wim J.

doi:10.1200/jco.2007.14.0566

Cited by 669 publications

(578 citation statements)

References 31 publications

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“…The GROINSS-V showed that both short-term as well as long-term morbidity were significantly decreased in patients who only underwent the SLN procedure compared to those who also underwent subsequent inguinofemoral lymphadenectomy. For lymphedema the percentages were 1.9% vs. 25.2% respectively and for recurrent erysipelas 0.4% vs. 16.2% [11]. Our hypothesis was that patients after a SLN procedure only might have a better quality of life due to less long-term morbidity.…”

Section: Introductionmentioning

confidence: 84%

“…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]. Frequently occurring sequelae of inguinofemoral lymphadenectomy are lymphedema, painful legs and recurrent erysipelas.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductionmentioning

confidence: 84%

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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“…As presented here, all patients with lymph node metastases died and had a significantly shorter survival compared to women without lymph node metastases. Two large studies revealed that sentinel node procedures can be performed in women presenting with a unifocal disease, a tumour size below 4 cm and clinically negative lymph nodes [11,12]. All cases but one in this study had tumour sizes exceeding 5 cm, and five women had clinically enlarged lymph nodes, with two women revealing no metastases in the final histology report.…”

Section: Discussionmentioning

confidence: 58%

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

et al. 2015

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Vulva cancer is the fourth leading gynaecological malignancy, accounting for approximately 4 % of all gynaecological cancers. Surgery represents the treatment of choice, and cases of advanced or recurrent vulvar cancers are to date a major challenge to multidisciplinary teams. Abdominoperineal excision (APE) in combination with vulvectomy and inguinal lymphadenectomy is the only curative treatment option. Patients' files of all women with squamous cell carcinoma of the vulva who underwent abdominoperineal resection were retrospectively reviewed with special regards to technical challenges the general surgeon will face. Seven women were enrolled in this retrospective study with a median age of 71 years (range 56-79 years). In six patients, the pelvic floor after abdominoperineal excision could be closed by direct suture of the levator muscles. One woman underwent abdominoperineal resection with closure of the defect using a vertical rectus abdominis myocutaneous (VRAM) flap. All women underwent radical vulvectomy, in five patients in combination with bilateral inguinal lymph node dissection. Operation time was 377 min (range 130-505 min). The median overall survival after surgery was 27 months (range 4-84 months), with a calculated 5-year survival rate of 42 %. Women with negative lymph nodes revealed a longer survival time after surgery compared to women with lymph node metastases (15.5 vs. 72 months; p=0.09). Abdominoperineal excisions represent a powerful tool in the multidisciplinary treatment regimen of advanced or recurrent vulvar cancer. Reconstruction of the pelvic floor usually does not require myocutaneous flaps, even when facing large tumours. Despite high complication rates, radical surgery was a feasible treatment with long-term survival potential without mortality.

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“…18 The application of the SLN concept for malignancies of intra-abdominal organs is still under evaluation and testing. SLN biopsy has been one of the most important innovations in surgical oncology in recent years; it is being reported as a less invasive procedure that brings more information to clinicians.…”

Section: Discussionmentioning

confidence: 99%

Minilaparoscopy and Sentinel Lymph Node in Uterine Cancer

Ferreira

Nogueira‐Silva

Miranda

et al. 2015

CRSLS

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Background: The sentinel lymph node (SLN) concept might minimize surgical aggressiveness in gynecological oncology, namely in cervical and endometrial malignancies. Therefore, we assessed the feasibility of SLN identification, dissection, and harvesting by using minilaparoscopic surgical instruments in an animal model. We compared the minilaparoscopic approach, which is known to bring important advantages, with the use of conventional laparoscopic instruments.

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Sentinel Node Dissection Is Safe in the Treatment of Early-Stage Vulvar Cancer

Cited by 669 publications

References 31 publications

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

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

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

Minilaparoscopy and Sentinel Lymph Node in Uterine Cancer

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