Title: Sentinel lymph node in vulvar cancer - a pilot study to identify and assessthe diagnostic value
Abstract: Introduction . Vulvar cancer is the fourth most common gynaecological malignancy, the treatment results of which still remain unsatisfactory. The poor outcome is probably due to advanced stages of the disease at diagnosis and/or from delays in the onset of complementary therapy which is necessary in case of the presence of lymph node metastases. These delays are, in turn, usually caused by complications brought on by extensive surgical excision. A i m. Our aim was to conduct a pilot study in order to design an optimal method of sentinel lymph node identification in patients with squamous cell carcinoma of the vulva and to assess the diagnostic value of the sentinel lymph node biopsy in this particular malignancy. Material and methods . The patients were considered as eligible for the study if they were to undergo radical vulvectomy due to squamous cell carcinoma stage T1-2, N0-2, M0. The sentinel lymph node was identified intraoperatively using a combined method: lymphoscintigraphy (gamma-camera scanning after the administration of Technetium Tc99m) and Patentblau V staining. Results . All the specimens were referred for histopathological examination as the lymph nodes were found to contain lymphatic tissue. The positive prognostic value of simultaneous application of both methods of sentinel lymph node identification was found to be 94.8%. Lymph node metastases were found in 13 cases out of a total of 40 operated inguinal basins. In 3 cases metastases were found in the sentinel nodes, while the remaining unilateral lymphatic nodes were cancerfree. We found no case of inguinal lymph node metastases in which the sentinel lymph node would be free of cancer metastases. Conclusions . It may be assumed that the combination of lymphoscintigraphy and Patentblau dying is an effective method of sentinel lymph node identification. In order to assess the diagnostic value of sentinel lymph node biopsy in the treatment of squamous cell carcinoma of the vulva it is necessary to study a larger group of patients over a longer follow-up period.
Publication Year: 2003
Publication Date: 2003-01-01
Language: en
Type: article
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Cited By Count: 3
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