Sentinel lymph node biopsy in vulvar cancer: a pilot study.

BACKGROUND

The aim of the pilot study was to assess the feasibility, efficacy, and accuracy of the sentinel lymph node biopsy (SLNB) procedure in vulvar cancer.

PATIENTS AND METHODS

From February 2003 to March 2007, 17 patients with vulvar cancer, clinical Stages I and II, underwent SLN (sentinel lymph node) detection, followed by a complete inguinal-femoral lymphadenectomy. Demographic, surgical, and pathologic data on all patients were reviewed.

RESULTS

17 patients underwent the SLNB procedure. Sixteen had vulvar carcinoma and one patient suffered from melanoma of the vulva. Midline localisation was done in 11 patients (64.7%). A total of 371 lymph nodes were resected. The median number of removed lymph nodes was 15 (range 2 to 81). Nineteen lymph nodes were positive with a maximum of six in one patient. Overall the detection rate for the sentinel lymph node was 88.2% (15 out of 17). One of the two patients with a non detectable sentinel node had positive lymph nodes. Eighty lymph nodes were detected as the sentinel node. The median number of sentinel nodes was five (range 0 to 11). Seventeen sentinel nodes were involved. The sentinel node was negative in nine patients; one of these had involved lymph nodes.

CONCLUSIONS

SLNB is feasible and safe to perform in vulvar cancer. Further evaluation is needed until new guidelines allow the use in early-stage vulvar cancer.