de Hullu J A, van der Zee A G J
Department of Gynaecologic Oncology, University Hospital Groningen, The Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2003 Aug;17(4):571-89. doi: 10.1016/s1521-6934(03)00038-5.
Vulvar cancer is a rare disease. Squamous-cell carcinomas account for 90% of vulvar cancers. The main mode of spread is lymphogenic to the inguinofemoral lymph nodes. Therefore, elective uni- or bilateral inguinofemoral lymphadenectomy is part of the standard treatment in combination with radical (wide) local excision of the vulvar tumour. Lymph drainage studies in relation to the biological behaviour of vulvar cancer are presented, as well as the anatomy and surgery of the groin. The sentinel lymph node procedure is a relatively new method of staging in vulvar cancer which may lead to the omission of inguinofemoral lymphadenectomy in those patients identified as not having inguinofemoral lymph node metastases. The accuracy of this technique appears to be high, but its safety still has to be proven. Moreover, the role of additional histopathological techniques for the examination of the sentinel lymph nodes needs to be established.
外阴癌是一种罕见疾病。鳞状细胞癌占外阴癌的90%。主要传播方式是通过淋巴管转移至腹股沟股淋巴结。因此，选择性单侧或双侧腹股沟股淋巴结清扫术是标准治疗的一部分，需结合外阴肿瘤的根治性（广泛）局部切除。本文介绍了与外阴癌生物学行为相关的淋巴引流研究，以及腹股沟的解剖结构和手术方法。前哨淋巴结活检是外阴癌分期的一种相对较新的方法，对于那些被确定没有腹股沟股淋巴结转移的患者，可能无需进行腹股沟股淋巴结清扫术。该技术的准确性似乎较高，但其安全性仍有待证实。此外，还需要确定用于检查前哨淋巴结的其他组织病理学技术的作用。
