这是个ABSTRACT: Posters Oral
SENTINEL LYMPH NODE IDENTIFICATION IN CANCER OF THE VULVA. A BRAZILIAN EXPERIENCE
Costa, R. L.R.1; Fukazawa, E. M.1; Coelho, F. R.G.1; Novik, P. R.1; Pinto, G. L.S.1; Casanova, S. M.S.1; Souza, R. A.Q.1; Peccini, K. V.1; Amoury, R. R.C. Jr1; Correa, M. A.R. Jr1; Issa, M. A.M.6; Bueno, C. A.T.2; Tavares, M. G.M.5; Lima, E. N.P.3
Author Information
1Dept of Gynecology, Sao Paulo, Brazil
2Dept of Pathology, Sao Paulo, Brazil
3Dept of Nuclear Medicine, Hospital do Cancer, Sao Paulo, Brazil
5Dept of Nuclear Medicine, Sao Paulo, Brazil
6Dept of Pathology – Instituto Brasileiro de Controle do Cancer, Sao Paulo, Brazil
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Background: Radical vulvectomy/wide excision with inguinofemoral dissection trough separated incisions had been the standard treatment for early vulvar carcinomas at ours institutions in the last two decades. Despite the good outcomes these approaches led to high complication rates specially wound breakdown and chronic leg edema. The detection of sentinel nodes (SLN) in the inguinal lymphatic chains may change this scenario.
Objectives: The goal of this study was to review our clinical experience with this technology for selected cases of cancer of the vulva.
Methods: Patients diagnosed with invasive carcinoma of the vulva T1–3 without groin palpable nodes treated during the period of 06/99 to 03/04 tough a combined technique employing lymphoscintigraphy with Technetium-99 m (Tc-99 m) phytate and intradermally injected blue dye to identify SLN in the inguinal lymphatic beds were included in this review. A handled collimated gamma counter (probe) was employed intraoperatively. Frozen sections was indicated for all dissected SLN > 6 mm in diameter.
Results: Fifty four patients with a median age of 62 were entered onto protocol and a total of 84 groin basins were dissected. A hundred twenty six SLN were identified (1.5 SLN/basin). In 19 SLN from 13 patients metastasis were detected by frozen section. The complementary lymphadenectomy revealed positive residual LN in 7 of these patients. No false-negative SLN were obtained. The specificities for detection of SLN was 71%, 54%, and 42% for lymphoscintigraphy, blue dye and probe respectively. This combined approach sowed a 100% sensibility rate.
Conclusions: Sentinel node identification is an accurate predictor of metastatic disease.
