Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva

Reviewers: Li Liu, MD
Source: Journal of Clinical Oncology, Volume 18:2811-2816, (August) 2000

Précis: Sentinel lymph node biopsy predicts metastasis of vulvar cancer

Introduction

A sentinel lymph node (SLN) is the first lymph node along the route of lymphatic drainage from a primary tumor. Sentinel lymph nodes receiving lymphatic drainage from a tumor can be removed by limited surgery and examined to determine whether more extensive lymph node dissection was necessary. Sentinel lymph node biopsy carries lower morbidity and cost than a complete lymph node dissection. In this study, the researchers looked at the feasibility of SLN biopsy in patients with squamous cell carcinoma of the vulva.

Method

A total of 59 patients with primary early-stage vulvar cancer underwent SLN biopsy. The researchers then performed radical excision of the primary tumor with inguinofemoral lymphadenectomy to verify their results.

Results

• SLN biopsy showed metastatic disease in 20 patients
• In the 39 other patients, no false-negative SLN were found.

Discussion

In this study, sentinel lymph node biopsy was highly accurate in predicting metastasis of early-stage vulvar cancer. Because of the high surgical complication rate of groin dissection in vulvar carcinoma, it would be extremely useful to have a reliable surrogate for the status of the lymph node to discover patients who have negative or only micrometastatic nodes and do not require a groin dissection. This report highlights the significant advantages that can be achieved using sentinel node biopsy in a variety of cancers.