Sykes, P and Eva, L and van der Griend, R and McNally, O and Blomfield, P and Brand, A and Tristram, A and Bergzoll, C and Petrich, S and Kenwright, D and Payne, K and Kellow, M and Innes, C and Harker, D and Perrin, L and Cohen, P and Jaaback, K and Simcock, B, Pathological process has a crucial role in sentinel node biopsy for vulvar cancer, Gynecologic Oncology, 153, (2) pp. 292-296. ISSN 0090-8258 (2019) [Refereed Article]
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.
|Item Type:||Refereed Article|
|Keywords:||vulvar neoplasms, sentinel lymph node biopsy, neoplasm recurrence, local, groin, female, pathology protocols|
|Research Division:||Medical and Health Sciences|
|Research Group:||Oncology and Carcinogenesis|
|Research Field:||Cancer Diagnosis|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cancer and Related Disorders|
|UTAS Author:||Blomfield, P (Associate Professor Penelope Blomfield)|
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