Groin recurrence rate in vulvar cancer patients treated with inguinal sentinel node biopsy

• Main Authors: Schütt, C, Volkmer, AK, Porn, AC, Fehm, T, Hampl, M
• Format: Conference Proceeding
• Language: eng ; ger
• ISSN: 0016-5751; 1438-8804
• DOI: 10.1055/s-0036-1592713

Objective: Sentinel lymphnode biopsy (SNB) is an option for patients with early stage vulvar cancer, groin recurrence rates are low and therapy related morbidity is minimal compared to complete inguinofemoral lymphadenectomy. The aim of this retrospective observational study was to evaluate the safety of SNB in women with vulvar cancer by assessing the groin recurrence rate in our center. Methods: Vulvar cancer patients who underwent SNB from May 2009 to May 2013 were eligible for this retrospective study, follow up ended in December 2015. Peritumoral injection of technetium-99 m-labeled nanocolloid followed by lymphoscintigraphy and intraoperative gamma probe detection was used to identify SLNs. Patients with negative SLN for metastases were followed clinically without further treatment. Patients with positive SLN underwent complete inguinofemoral lymphnode dissection followed by standard treatment protocols. Results: 78 patients with pT1b/pT2 vulvar cancer underwent SNB. The mean age was 54 years (range 21 – 91). The median follow-up was 46 months (range 31 – 79). Identification of a sentinel lymph node by lymphoscintigraphy was successful in 96% of 78 cases, the intraoperative detection rate was 97%. In 15 of 78 patients sentinel lymph nodes were positive, therefore they received complete inguinofemoral lymphnode dissection. One out of these patients developed groin metastases (recurrence rate 6.7%). Only 2 of 63 patients with initially negative SNB developed lymph node metastases during follow-up, resulting in a recurrence rate of 3.2%. Conclusions: In our hands SNB is a safe procedure in early stage vulvar cancer with a recurrence rate comparable to standard treatment and lower mobidity.