Pathological process has a crucial role in sentinel node biopsy for vulvar cancer

Peter Sykes, Lois Eva, Rachael van der Griend, Orla McNally, Penelope Blomfield, Alison Brand, Amanda Tristram, Cecile Bergzoll, Simone Petrich, Diane Kenwright, Kathryn Payne, Mayada Kellow, Carrie Innes, Dianne Harker, Lewis Perrin, Paul Cohen, Ken Jaaback, Bryony Simcock

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Objectives To report the interim findings of an audit of the outcomes of sentinel node (SN) biopsy performed as a replacement for groin node dissection in women with early stage vulvar cancer in routine clinical practice in Australia and New Zealand. Methods A prospective multi-center study in 8 participating centers. Eligible patients had squamous cell carcinomas clinically restricted to the vulva <4 cm in diameter. SN procedures and pathological assessment were to be performed in accordance with the methods published by the GROINSS-V collaboration [1]. Results 130 women with apparent early stage vulvar cancer were enrolled. Seventeen women subsequently did not meet the eligibility criteria and were excluded. SNs were identified in 111/113 of the remaining women. Twenty-two women had positive nodes. Sixteen of these women had at least 12 months follow up and 7 (44%) had recurrent disease. Eighty-nine women had only negative nodes. Seventy-four of these women had at least 12 months follow up and 6 (8%) had recurrent disease (including 2 [2.7%] with recurrence in the groin). On subsequent review of the two women with negative SNs who had groin recurrences, it was found that the recommended pathology protocol had not been followed. In both cases, SN metastases were identified following serial sectioning of the nodes. Conclusions SN biopsy is feasible in routine clinical practice. However, undetected metastases in a removed SN may be associated with groin recurrence. To ensure patient safety, strict adherence to the pathology protocol is an essential component in the utilization of the sentinel lymph node technique in vulvar cancer.
Original languageEnglish
Pages (from-to)292-296
Number of pages5
JournalGynecologic Oncology
Volume153
Issue number2
Early online date24 Feb 2019
DOIs
Publication statusPublished - May 2019

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