Carcopino Xavier, Houvenaeghel Gilles, Buttarelli Max, Charaffe-Jauffret Emmanuelle, Gonzague Laurence, Rossi Isabelle
Département de Chirurgie, Institut Paoli-Calmettes, 232 bd Sainte-Marguerite, 13005 Marseilles.
Bull Cancer. 2005 May 1;92(5):489-97.
The aim of this study was to investigate the feasibility and the morbidity of sentinel lymph node detection in patients with vulvar carcinoma. In 15 patients with vulvar squamous cell carcinoma, the inguinal sentinel lymph nodes was detected using both peritumoral injection of technetium-99m sulfur colloid and isosuflan blue before the surgical time. The detection of the inguinal sentinel lymph node was never completed by an inguinal lymphadenectomy. In case of metastatic lymph node, patients were treated by complementary inguinal irradiation. A total of 19 inguinal node dissection were performed. The sentinel lymph node was identified in 18/19 (94.7%) groin dissections. A total of 38 sentinel lymph nodes were removed. 4 patients were found to have metastatic lymph node (26.7%) with a total of 6 metastatic lymph nodes. The postoperative morbidity was minimal, with only one patient presenting a permanent edema of the extremity (6.7%) after complementary inguinal irradiation. We confirm the results of previous studies that sentinel node dissection appears to be technically feasible in patients with vulvar carcinoma. This may reduce the morbidity of usual inguinal lymphadenectomy without under-evaluate the nodal status. This procedure could be implemented in future therapy concepts.
本研究的目的是探讨在外阴癌患者中前哨淋巴结检测的可行性及发病率。对15例外阴鳞状细胞癌患者,术前采用瘤周注射99m锝硫胶体和异硫蓝两种方法检测腹股沟前哨淋巴结。腹股沟淋巴结清扫术从未完成腹股沟前哨淋巴结的检测。若出现转移性淋巴结,患者接受辅助腹股沟放疗。共进行了19例腹股沟淋巴结清扫术。在19例(94.7%)腹股沟清扫术中识别出前哨淋巴结。共切除38个前哨淋巴结。4例患者发现有转移性淋巴结(26.7%),共有6个转移性淋巴结。术后发病率极低,仅1例患者在辅助腹股沟放疗后出现肢体永久性水肿(6.7%)。我们证实了先前研究的结果,即前哨淋巴结清扫术在外阴癌患者中似乎在技术上是可行的。这可能会降低常规腹股沟淋巴结清扫术的发病率,而不会低估淋巴结状态。该手术可应用于未来的治疗方案中。