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

Autor: Bryony Simcock, Mayada Kellow, Cecile Bergzoll, Peter Sykes, Penelope Blomfield, Ken Jaaback, Carrie R. H. Innes, Diane Kenwright, Kathryn Payne, Alison Brand, Paul A. Cohen, Lewis Perrin, Orla McNally, Lois Eva, Dianne Harker, Rachael van der Griend, Simone Petrich, Amanda Tristram
Rok vydání: 2019
Předmět:
Adult
0301 basic medicine
medicine.medical_specialty
Sentinel lymph node
Groin
Vulva
03 medical and health sciences
0302 clinical medicine
Biopsy
Pathology
medicine
Humans
Prospective Studies
Stage (cooking)
Aged
Neoplasm Staging
Aged
80 and over
Vulvar neoplasm
Medical Audit
Vulvar Neoplasms
medicine.diagnostic_test
Sentinel Lymph Node Biopsy
business.industry
General surgery
Australia
Obstetrics and Gynecology
Middle Aged
Sentinel node
Vulvar cancer
medicine.disease
Outcome and Process Assessment
Health Care
030104 developmental biology
medicine.anatomical_structure
Oncology
Lymphatic Metastasis
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Feasibility Studies
Lymph Node Excision
Female
Guideline Adherence
Patient Safety
Neoplasm Recurrence
Local
Sentinel Lymph Node
business
New Zealand
Zdroj: Gynecologic Oncology. 153:292-296
ISSN: 0090-8258
Popis: 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.A prospective multi-center study in 8 participating centers. Eligible patients had squamous cell carcinomas clinically restricted to the vulva4 cm in diameter. SN procedures and pathological assessment were to be performed in accordance with the methods published by the GROINSS-V collaboration [1].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.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.
Databáze: OpenAIRE
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