Introduction/Background Lymph node status is the most important prognostic factor in vulvar cancer. Histologically, sentinel nodes may be representative of the status of the other regional nodes. Identification and histopathologic evaluation of sentinel nodes could then have a significant impact on clinical management and surgery. The aim of the study was to assess the sensitivity, negative prognostic value, accuracy and false negativity of the sentinel lymph node (SLN) procedure during 14 years.
Methodology From June 2004 to Deceember 2017, 112 patients with vulvar cancer, clinical stages FIGO IA-IB, underwent surgical tretament in onco-gynecologic center of University Hospital Ostrava. Demographic, surgical, and pathologic data on all patients were prospectively entered in a database. Of 86 women with early-stage squamous cell vulvar cancer included in the study, nineteen had lateral lesions and 67 had midline lesions. SLN detection was performed by using a radioactive tracer and blue dye, followed by radical vulvectomy or radical wide excision with uni ⁄bilateral inguinofemoral lymphadenectomy. SLNs were subsequently examined with haematoxylin-eosin and immunohistochemistry.
Results Eighty- six patients underwent the SLN procedure by combined method. The detection rate per patient was 97,7%, and side specific detection rate was 88,1%. For 19 patients with lateral lesion the detection rate per patient and side specific detection rate was 100% and for patients with midline tumor 97,0% a 87,0% respectively. In total, fifty-one positive SLNs were detected in thirty-two of 86 patients (37,2%). From a total 51 positive SLNs, micrometastases were found in ten SLNs. We experienced only one case with a false negativity of SLN. Sensitivity, negative predictive value, accuracy and false negativity of SLN detection were 96,9%, 98,1%, 97,7% and 3.1% respectively.
Conclusion The SLN biopsy performed by an experienced team during long time period is a accurate method, with high accuracy and low false negativity in patients with early-stage vulvar cancer.
Disclosure Nothing to disclose.
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