engleski

Safety of sentinel node biopsy in vulvar cancer figo staging IB and II

In our study 29 patients with early stage carcinoma of the vulva underwent an inguinal sentinel node dissection followed by bilateral inguinofemoral lymphadenectomy. Before operation technetium- 99mlabeled nanocolloid was injected intradermally around the tumor. Using a gamma camera we recorded images and SLN locations were marked on the groin skin. During operation we identified SLNs using a handheld gamma-detection probe. After dissection of the SLNs operating field was checked with gamma-detection probe and if it was negative a standard bilateral inguinofemoral lymphadenectomy was performed.The results of histopathology of the SLNs were compared with those of the non-SLNs. We also compared pathologic evaluation of lymph nodes with H&E staining in comparison with immunohistochemical pancytokeratin antibody AE1/AE3 staining.We detected SLN in 28 of 29 patients (96.5%). Total of 335 lymph nodes were obtained (61 SLNs and 274 inguinofemoral lymph nodes). SLNs were positive in 7 patients. 16 SLNs were positive with H&E staining, and 17 SLNs were positive with AE1/AE3 staining. In all patients with negative SLNs also inguinofemoral lymph nodes were negative. Our results indicate that labeling of SLNs with technetium-99m is feasible procedure with detection rate of 96.5%. Also SLNs pathological status is safe in predicting the pathological status of the remaining groin nodes. That suggests that inguinofemoral lymphadenectomy can be avoided in cases of a negative SLNs. Combining immunohistochemical pancytokeratin antibody AE1/AE3 staining and H&E staining we found no falsenegative SLN.

vulvar cancer ; sentinel node

Abstracts presented at the 17th International Meeting of the European Society of Gynaecological Oncology Poster Shift II