Clinical Significance of Sentinel Lymph Node Detection in Vulvar Cancer.

Rhim, Chae Chun; Hwang, Seong Jin; Park, Jong Sup; Namkoong, Sung Eun

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Obstet Gynecol Sci > Volume 45(6); 2002 > Article

Original Article

Korean Journal of Obstetrics & Gynecology 2002;45(6):940-945.
Published online: June 1, 2002

Clinical Significance of Sentinel Lymph Node Detection in Vulvar Cancer.

Chae Chun Rhim, Seong Jin Hwang, Jong Sup Park, Sung Eun Namkoong

Department of Obstetrics and Gynecology Catholic University Medical College, Seoul, Korea.

Abstract

OBJECTIVE
The purpose of this study is to evaluate the validity of sentinel lymph node detection and the possibility of clinical application in treatment of vulvar cancer patients. PATIENTS AND METHODS: From March 2001 to January 2002, four patients with vulvar cancer were eligible for this study. All the patients were preoperative technetium-99 m colloid albumin and intraoperative isosulfan blue dye injection intradermally at the junction of tumor mass and normal skin. Superficial lymphatic channels and groin lymph node dissections were made to detect sentinel lymph node and then complete inguinofemoral lymph nodes dissection was performed. All the sentinel lymph nodes were sent to pathologic department for frozen biopsy. RESULTS: Ten sentinel lymph nodes were identified in one-hundred and ten groin lymph nodes. All the ten sentinel lymph nodes showed benign. There was no case that non-sentinel lymph nodes were positive in the presence of negative sentinel lymph nodes by frozen biopsy (negative predictive value was 100%). CONCLUSION: Sentinel lymph nodes detection by combination use of technetium-99 m colloid albumin and isosulfan blue dye injection was simple and accurate in our preliminary study. To reduce postoperative morbidity, lymphedema and to minimize extensive inguinofemoral lymph nodes dissection, sentinel lymph node frozen biopsy may be a reasonable alternatives and a suitable method for limited control of vulvar cancer. This preliminary study showed the possibility of clinical application of sentinel lymph node detection in vulvar cancer surgery.

Keywords: vulvar cancer; radical vulvectomy and inguinofemoral node dissection; sentinel lymph node

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