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Pathological process has a crucial role in sentinel node biopsy for vulvar cancer

journal contribution
posted on 2023-05-20, 05:30 authored by Sykes, P, Eva, L, van der Griend, R, McNally, O, Penelope BlomfieldPenelope Blomfield, Brand, A, Tristram, A, Bergzoll, C, Petrich, S, Kenwright, D, Payne, K, Kellow, M, Innes, C, Harker, D, Perrin, L, Cohen, P, Jaaback, K, Simcock, B

Objectives: To report the interim findings of an audit of the outcomes of sentinel node (SN) biopsy performed as a replacement for groin node dissection in women with early stage vulvar cancer in routine clinical practice in Australia and New Zealand.

Methods: A prospective multi-center study in 8 participating centers. Eligible patients had squamous cell carcinomas clinically restricted to the vulva <4 cm in diameter. SN procedures and pathological assessment were to be performed in accordance with the methods published by the GROINSS-V collaboration.

Results: 130 women with apparent early stage vulvar cancer were enrolled. Seventeen women subsequently did not meet the eligibility criteria and were excluded. SNs were identified in 111/113 of the remaining women. Twenty-two women had positive nodes. Sixteen of these women had at least 12 months follow up and 7 (44%) had recurrent disease. Eighty-nine women had only negative nodes. Seventy-four of these women had at least 12 months follow up and 6 (8%) had recurrent disease (including 2 [2.7%] with recurrence in the groin). On subsequent review of the two women with negative SNs who had groin recurrences, it was found that the recommended pathology protocol had not been followed. In both cases, SN metastases were identified following serial sectioning of the nodes.

Conclusions: SN biopsy is feasible in routine clinical practice. However, undetected metastases in a removed SN may be associated with groin recurrence. To ensure patient safety, strict adherence to the pathology protocol is an essential component in the utilization of the sentinel lymph node technique in vulvar cancer.

History

Publication title

Gynecologic Oncology

Volume

153

Pagination

292-296

ISSN

0090-8258

Department/School

Tasmanian School of Medicine

Publisher

Academic Press Inc Elsevier Science

Place of publication

525 B St, Ste 1900, San Diego, USA, Ca, 92101-4495

Rights statement

Copyright 2019 Elsevier Inc.

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified; Women's and maternal health

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