Sentinel lymph node procedure in early-stage vulvar cancer: Correlation of lymphoscintigraphy with surgical outcome and groin recurrence.

Autor: Warmerdam DHM; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: d.h.m.warmerdam@lumc.nl., van Geloven N; Department of Biomedical Data Sciences (section Medical Statistics), Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: N.van_Geloven@lumc.nl., Beltman JJ; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: J.J.Beltman@lumc.nl., De Kroon CD; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: C.d.de_kroon@lumc.nl., Rietbergen DDD; Daphne D.D. Rietbergen: Department of Radiology, Section Nuclear Medicine, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: d.d.d.rietbergen@lumc.nl., van Poelgeest MIE; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: M.I.E.van_Poelgeest@lumc.nl., Gaarenstroom KN; Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: K.N.Gaarenstroom@lumc.nl.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2023 Oct; Vol. 49 (10), pp. 107006. Date of Electronic Publication: 2023 Aug 03.
DOI: 10.1016/j.ejso.2023.107006
Abstrakt: Introduction: In early-stage vulvar squamous cell carcinoma (VSCC) a sentinel lymph node (SLN) procedure is regarded successful if at least one SLN is removed with minimal residual radioactivity. An inguinofemoral lymphadenectomy is considered if not all SLNs visualized on lymphoscintigraphy can be found, with subsequent increased morbidity. We correlated lymphoscintigraphy findings with surgical outcome and groin recurrence with focus on number of SLNs found.
Methods: This study concerns a retrospective cohort of 171 women treated for early-stage VSCC who underwent a SLN procedure between 2000 and 2020. The risk of groin recurrence was compared after either a successful or complete SLN procedure, i.e. removal of all SLNs that were visualized on lymphoscintigraphy.
Results: In 13 (7.6%) groins of 171 patients SLN visualization on lymphoscintigraphy failed. In 230 of the 246 (93.5%) groins in which a SLN was visualized, at least one SLN was found during surgery. In 224 of the 246 (91.1%) groins the SLN procedure was regarded either successful (n = 14) or complete (n = 210). An isolated groin recurrence was documented in 5 out of 192 (2.6%, 95%-CI; 0.34 to 4.9) SLN-negative groins after a median follow-up of 47.0 months. All recurrences were noted in the complete SLN group (5/180 groins). The difference with the successful SLN group (0/12 groins) was not significant.
Conclusion: Risk of groin recurrence was 2.6% after SLN negative biopsy in early-stage VSCC. The risk appeared not increased if at least one SLN was found with minimal residual radioactivity, in case more SLNs were visualized on lymphoscintigraphy.
(© 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)
Databáze: MEDLINE
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