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Characteristics of sentinel lymph nodes’ metastatic involvement in early stage of vulvar cancer
Author(s) -
KLÁT Jaroslav,
ŠEVČÍK Libor,
ŠIMETKA Ondřej,
GRÁF Petar,
WALOSCHEK Tomáš,
KRAFT Otakar,
JALUVKOVÁ Zdena,
PROCHÁZKA Martin
Publication year - 2009
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2009.01073.x
Subject(s) - vulvar cancer , medicine , sentinel lymph node , radical vulvectomy , stage (stratigraphy) , vulvectomy , breast cancer , lymph , groin , biopsy , cancer , lymph node , vulva , radiology , pathology , surgery , paleontology , biology
Background: Nodal involvement is one of the most significant prognostic factors in early‐stage vulvar cancer. Aims: To determine the diagnostic accuracy of sentinel lymph node (SLN) detection in early‐stage vulvar cancer and to describe the characteristics of metastatic lymph node involvement. Methods: Of 23 women with early‐stage squamous cell vulvar cancer included in the study, five had lateral lesions and 18 had midline lesions. SLN detection was performed by using a radioactive tracer and blue dye, followed by radical vulvectomy or radical wide excision with uni/bilateral inguinofemoral lymphadenectomy, depending on tumour size and localization. SLNs were subsequently examined with haematoxylin–eosin and immunohistochemistry. Results: The SLN detection was successful in all 23 women (100%) and in 38 of 41 groins (92.3%) tested. The total number of SLNs was 67, with an average of 1.76 per groin. In total, 20 positive SLNs were detected in 14 of 23 patients. From a total of 20 positive SLNs, micrometastases were found in five SLNs and isolated tumour cells in one SLN. We experienced one case with a false negativity of SLN. Sensitivity, negative predictive value, accuracy and false negativity of SLN detection were 93.3%, 88.8%, 95.6% and 7.1% respectively. Conclusion: The SLN biopsy performed by an experienced team is a feasible method, with high accuracy in patients with early‐stage vulvar cancer. Prognostic value of micrometastases should be confirmed in further studies.