Canlorbe G, Rouzier R, Bendifallah S, Chéreau E
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
Gynecol Obstet Fertil. 2012 Nov;40(11):647-51. doi: 10.1016/j.gyobfe.2012.07.014. Epub 2012 Sep 15.
Vulvar cancer is usually treated with vulvectomy and bilateral groin lymphadenectomy, which result in serious morbidities while only 30% of patients have positive nodes. The sentinel node technique has good sensitivity and specificity for detecting lymph node involvement while minimizing postoperative morbidity. The aim of this study was to evaluate the specific and overall survival impact of sentinel lymph node procedure versus inguinofemoral lymphadenectomy in patients with vulvar cancer.
This is a retrospective study from the Surveillance, Epidemiology, and End Results (SEER) database on patients with vulvar squamous cell carcinoma, T1 or T2 stage, metastatis-free, followed between 2004 and 2008.
One thousand and thirty eight patients had a systematic groin lymphadenectomy and 56 a sentinel node technique (including 22 with an associated lymphadenectomy because of a positive sentinel node). There is no significant difference in overall or specific survival between the two groups. In multivariate analysis, age, T stage and nodal status are prognostic factors for overall and specific mortality (P<0.05).
Sentinel node technique is not associated with an excess risk of mortality or recurrence.
外阴癌通常采用外阴切除术和双侧腹股沟淋巴结清扫术进行治疗，这会导致严重的并发症，而只有30%的患者淋巴结呈阳性。前哨淋巴结技术在检测淋巴结受累方面具有良好的敏感性和特异性，同时能将术后并发症降至最低。本研究的目的是评估前哨淋巴结手术与腹股沟股淋巴结清扫术对外阴癌患者特异性生存和总生存的影响。
这是一项基于监测、流行病学和最终结果（SEER）数据库的回顾性研究，研究对象为2004年至2008年间随访的T1或T2期、无转移的外阴鳞状细胞癌患者。
1038例患者接受了系统性腹股沟淋巴结清扫术，56例采用了前哨淋巴结技术（其中22例因前哨淋巴结阳性而同时进行了淋巴结清扫术）。两组患者的总生存或特异性生存无显著差异。多因素分析显示，年龄、T分期和淋巴结状态是总生存和特异性死亡的预后因素（P<0.05）。
前哨淋巴结技术与额外的死亡或复发风险无关。
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