Validation of the accuracy of the sentinel lymph node procedure in patients with vulvar cancer: Results of a multicenter study in Germany

Hampl, Monika; Hantschmann, Peer; Michels, W; Hillemanns, Peter

doi:10.1016/j.ygyno.2008.08.007

Cited by 140 publications

(78 citation statements)

References 52 publications

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“…Hampl on routine SLN biopsy in 127 patients with T1-T3, VC in 125 patients, 36 of 39 cases dissected lymph node-positive patients with positive SLN biopsy, a sensitivity of 92.3%. 13 3 false negative SLN patients (7.7%) are located in the midline of the primary tumor. Ultra installments negative predictive value of sentinel lymph node biopsy (NPV) from 97% to 100% Studies have shown that less than 4 cm, T1 or T2, infiltration depth of less than 1 mm of vulvar squamous cell carcinoma were treated with sentinel lymph node biopsy has better security and accuracy.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of vulvar cancer

Thakur

Xuehua

Mengli

et al. 2013

Int J Reprod Contracept Obstet Gynecol

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Background: The purpose of this study is to understand the incidence, related factors, and the prognosis factors in order to avoid risk, proper method of diagnosis and treatment and reduce complications and provide the basis. Methods: 85 Vulvar cancer (VC) patients treated in our hospital from 2002.10 to 2012.10 were collected and analyzed by retrospective comparative methods. SPSS19.0 application software was used for the statistical analysis. The clinical data are analyzed by chi-square and F test statistic methods. P < 0.05 was a significant difference between the judgment standard. Results: During 10 years, we treated 3391 cases of the primary malignant tumors including 85 VC cases; VC was 2.89% (85/3391). The age was between 24~88 years old, mean was 57.09±12.93 yrs. old, variable age of the VC had been juvenescence trend (F=6. 013, P=0.016). The differences between the urban and rural residential area have some influence to the onset of VC. Rural patients are more than urban patients. By statistical analysis, region distribution in these two groups was remarkably different=4.16,P=0.045<0.05, but the urban proportion of patients in different years has no difference (χ2=0.080, P=0.777). Conclusion: The number of cases increased progressively in young age. VC patients were more in rural area than urban. History of malignant tumor and obesity has the positive correlation with VC. High-risk groups should be alert to the possibility of VC. Preoperative diagnosis should be Colposcopic, biopsy in order to improve the accuracy of earlier diagnosis. Vulvar resects have an effect on the healing of the incision. Follow-up rate is low; It is difficult to say statistically survival rate is 5 years. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 268-276

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of vulvar cancer

Thakur

Xuehua

Mengli

et al. 2013

Int J Reprod Contracept Obstet Gynecol

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“…To obviate the negative side effects of full ILND, the application of the less extensive sentinel lymph node procedure is currently explored in patients with primary SCC. 11 The SLN identification by a technetium99m-labelled nanocolloid (alone or with blue dye) appears to be the most accurate method, with a sensitivity of 97% as reported for pooled data published between 1979 and 2004. 12 Positive non-sentinel nodes (NSLN) in the presence of negative SLN (i.e.…”

Section: Introductionmentioning

confidence: 91%

“…16 Regarding the oncological safety of the SLN procedure, the data provided by a large German multicenter observational study on the accuracy and safety of SLN detection in early vulvar cancer, indicates that it appears safe to omit further lymph node dissection in case of a negative SLN from the groin. 11 However, the SLN technique in SCC contains many nonstandardized variables. This includes the type of the radiocolloid (unfiltered or filtered particles), the use of combined tracers (combination with blue dye or nanocolloid alone), the method of injection (intratumorally or peritumorally) as well as the timing of administration (pre-or intraoperatively).…”

Section: Contextmentioning

confidence: 99%

Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intra-operative mapping with technetium-99m-labeled nanocolloid

Klar

Bossart

Stickeler

et al. 2011

European Journal of Surgical Oncology (EJSO)

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To cite this version:M. Klar, M. Bossart, E. Stickeler, I. Brink, M. Orlowska-Volk, et al.. Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intraoperative mapping with technetium-99m-labeled nanocolloid. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (9) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT Key words /MeSH terms:Vulvar carcinoma, sentinel lymph node, technetium-99m nanocolloid Conflict of interestThe authors declare no conflict of interest M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 Abstract Aims:Sentinel lymph node (SLN) mapping appears to be feasible in patients with primary vulvar cancer. Previous protocols describe the injection of the technetium-99m-nanocolloid at least 3 hours before surgery which involves two invasive procedures for the patient. In this study, we assessed the feasibility, safety, and accuracy of an intraoperative rather than preoperative SLN mapping in patients with primary vulvar cancer. Methods:Patients with histologically confirmed squamous cell vulvar cancer and clinically FIGO stage Ib disease underwent intraoperative SLN mapping by intradermal injection of the nanocolloid around the tumor. SLN were identified and removed before a complete inguino-femoral lymphnode dissection was performed. Surgical and pathologic data on all patients were prospectively entered into a database. Results:A SLN procedure was performed in 16 patients; 3 patients received unilateral lymphadenectomy, and 13 women underwent surgery on both groins. In all groins but 4 at least one SLN was clearly identified (detection rate 25/29, 86%). A median number of 2 SLN and 4 non-SLN per groin were removed. 3 of 16 patients (19 %) had metastatic disease in the lymph nodes. There was no false negative SLN result. Conclusion:Intraoperative SLN detection seems feasible in patients with early stage vulvar cancer. More patients need to be enrolled in this ongoing study before this more convenient technique can be considered safe.

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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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Validation of the accuracy of the sentinel lymph node procedure in patients with vulvar cancer: Results of a multicenter study in Germany

Cited by 140 publications

References 52 publications

Clinical analysis of vulvar cancer

Clinical analysis of vulvar cancer

Sentinel lymph node detection in patients with vulvar carcinoma; Feasibility of intra-operative mapping with technetium-99m-labeled nanocolloid

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

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