Sentinel lymph node biopsy in vulvar cancer: a pilot study.

BACKGROUND: The aim of the pilot study was to assess the feasibility, efficacy, and accuracy of the sentinel lymph node biopsy (SLNB) procedure in vulvar cancer. PATIENTS AND METHODS: From February 2003 to March 2007, 17 patients with vulvar cancer, clinical Stages I and II, underwent SLN (sentinel lymph node) detection, followed by a complete inguinal-femoral lymphadenectomy. Demographic, surgical, and pathologic data on all patients were reviewed. RESULTS: 17 patients underwent the SLNB procedure. Sixteen had vulvar carcinoma and one patient suffered from melanoma of the vulva. Midline localisation was done in 11 patients (64.7%). A total of 371 lymph nodes were resected. The median number of removed lymph nodes was 15 (range 2 to 81). Nineteen lymph nodes were positive with a maximum of six in one patient. Overall the detection rate for the sentinel lymph node was 88.2% (15 out of 17). One of the two patients with a non detectable sentinel node had positive lymph nodes. Eighty lymph nodes were detected as the sentinel node. The median number of sentinel nodes was five (range 0 to 11). Seventeen sentinel nodes were involved. The sentinel node was negative in nine patients; one of these had involved lymph nodes. CONCLUSIONS: SLNB is feasible and safe to perform in vulvar cancer. Further evaluation is needed until new guidelines allow the use in early-stage vulvar cancer.