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Effects of Previous Surgery on the Detection of Sentinel Nodes in Women With Vulvar Cancer
  1. Tessa A. Ennik, MD*,,
  2. David G. Allen, FRANZCOG, CGO, PhD*,
  3. Ruud L.M. Bekkers, MD, PhD,
  4. Simon E. Hyde, FRANZCOG, CGO* and
  5. Peter T. Grant, FRANZCOG, CGO*
  1. * Department of Gynecological Oncology, Mercy Hospital for Women, Melbourne, Australia; and
  2. Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
  1. Address correspondence and reprint requests to Tessa A. Ennik, MD, Professor Bellefroidstraat 167, 6525 AG Nijmegen, the Netherlands. E-mail: tessa{at}ennik.com.

Abstract

Background There is a growing interest to apply the sentinel node (SN) procedure in the treatment of vulvar cancer. Previous vulvar surgery might disrupt lymphatic patterns and thereby decrease SN detection rates, lengthen scintigraphic appearance time (SAT), and increase SN false-negative rate. The aims of this study were to evaluate the SN detection rates at the Mercy Hospital for Women in Melbourne and to investigate whether previous vulvar surgery affects SN detection rates, SAT, and SN false-negative rate.

Methods Data on all patients with vulvar cancer who underwent an SN procedure (blue dye, technetium, or combined technique) from November 2000 to July 2010 were retrospectively collected.

Results Sixty-five SN procedures were performed. Overall detection rate was 94% per person and 80% per groin. Detection rates in the group of patients who underwent previous excision of the primary tumor were not lower compared with the group without previous surgery or with just an incisional biopsy. There was no statistical significant difference in SAT between the previous excision group and the other patients. None of the patients with a false-negative SN had undergone previous excision.

Conclusions Results indicate that previous excision of a primary vulvar malignancy does not decrease SN detection rates or increase SN false-negative rate. Therefore, the SN procedure appears to be a reliable technique in patients who have previously undergone vulvar surgery. Previous excision did not significantly lengthen SAT, but the sample size in this subgroup analysis was small.

  • Vulvar cancer
  • Sentinel lymph node
  • Previous surgery
  • Sentinel node detection rate
  • Sentinel node false-negative rate
  • Scintigraphic appearance time

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Footnotes

  • The authors have no conflict of interest to declare.

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