Department of Gynecological Oncology, Mercy Hospital for Women, Melbourne, Australia.
Int J Gynecol Cancer. 2011 Dec;21(9):1679-83. doi: 10.1097/IGC.0b013e31822dbe3c.
There is a growing interest to apply the sentinel node (SN) procedure in the treatment of vulvar cancer. Previous vulvar surgery might disrupt lymphatic patterns and thereby decrease SN detection rates, lengthen scintigraphic appearance time (SAT), and increase SN false-negative rate. The aims of this study were to evaluate the SN detection rates at the Mercy Hospital for Women in Melbourne and to investigate whether previous vulvar surgery affects SN detection rates, SAT, and SN false-negative rate.
Data on all patients with vulvar cancer who underwent an SN procedure (blue dye, technetium, or combined technique) from November 2000 to July 2010 were retrospectively collected.
Sixty-five SN procedures were performed. Overall detection rate was 94% per person and 80% per groin. Detection rates in the group of patients who underwent previous excision of the primary tumor were not lower compared with the group without previous surgery or with just an incisional biopsy. There was no statistical significant difference in SAT between the previous excision group and the other patients. None of the patients with a false-negative SN had undergone previous excision.
Results indicate that previous excision of a primary vulvar malignancy does not decrease SN detection rates or increase SN false-negative rate. Therefore, the SN procedure appears to be a reliable technique in patients who have previously undergone vulvar surgery. Previous excision did not significantly lengthen SAT, but the sample size in this subgroup analysis was small.
人们越来越有兴趣将前哨淋巴结（SN）手术应用于外阴癌的治疗中。先前的外阴手术可能会破坏淋巴模式，从而降低 SN 的检出率，延长闪烁显像出现时间（SAT），并增加 SN 的假阴性率。本研究旨在评估墨尔本 Mercy 医院的 SN 检出率，并探讨先前的外阴手术是否会影响 SN 的检出率、SAT 和 SN 的假阴性率。
回顾性收集了 2000 年 11 月至 2010 年 7 月期间所有接受 SN 手术（蓝染剂、锝或联合技术）的外阴癌患者的数据。
共进行了 65 次 SN 手术。总体检出率为每人 94%，每侧腹股沟 80%。与未行先前手术或仅行切开活检的患者相比，先前切除原发肿瘤的患者组的检出率并不低。在 SAT 方面，先前切除组与其他患者之间无统计学差异。所有 SN 假阴性患者均未行先前切除。
结果表明，先前切除原发性外阴恶性肿瘤不会降低 SN 的检出率或增加 SN 的假阴性率。因此，SN 手术在外阴手术史患者中似乎是一种可靠的技术。先前的切除并未显著延长 SAT，但本亚组分析的样本量较小。
