Sentinel Lymph Nodes Identification in Vulvar Cancer - Methods and Technique

Czech version

Authors: Lukáš Rob ¹; H. Robová ¹; M. Pluta ¹; P. Strnad ¹; J. Kačírek ¹; R. Chmel ¹; L. Teslík ¹; P. Škapa ²; K. Táborská ³
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a Fakultní nemocnice Motol, Praha, přednosta doc. MUDr. L. Rob, CSc. ¹; Ústav patologie a molekulární medicíny 2. LF UK a Fakultní nemocnice Motol, Praha, přednosta prof. MUDr. R. Kodet, CSc. ²; Ústav endokrinologie a nukleární medicíny 2. LF UK a Fakultní nemocnice Motol, Praha, přednosta doc. MUDr. P. Vlček, CSc. ³
Published in: Ceska Gynekol 2006; 71(4): 298-301
Category: Original Article

Overview

Objective:
To evaluate detection of sentinel lymph nodes (SLN) in squamous vulvar cancer with blue dye and ^99mTc. The study describes technique of application, timing, management, detection rate (DR), specific side detection rate (SSDR) and false negative rate.

Design:
Prospective clinical study.

Setting:
Department of Obstetrics and Gynecology, Charles University Prague, 2^nd Medical Faculty, Teaching Hospital Motol.

Patients and methods:
46 women with squamous cell carcinoma tumors stage I or II, <4 cm with no clinical suspect lymph nodes were included. Blue dye alone was used in 16 women and the combination of ^99mTc and blue dye was used in 30 women. Radiocoloid 99mTc was applied 3-5 hours and blue dye 3-5 minutes prior to ingvinal incision.

Results:
We detected 88 SLN in 61 inguinal spaces. The detection rate in the blue dye group was 68.8 % (11 cases). One false negative SLN (6.3 %) appeared in this group. In blue dye+ ^99mTc group detection rate was 100 % with no false negative SLN.

Conclusion:
Detection of SLN in squamous vulvar cancer with the combination of ^99mTc and blue dye was statistically significantly more effective than using the blue dye alone.

Key words:
vulvar cancer, sentinel lymph node, technetium ^99mTc, blue dye, lymphadenectomy