Less invasive technique possible for vulvar cancer

Sentinel lymph node dissection in women with vulvar malignancies allowed gynecologic oncology surgeons to identify and remove just the sentinel nodes and follow the patients for complications and recurrence, according to new research. The study was presented at the main plenary session of the annual meeting of the Society of Gynecologic Oncologists in Tampa, Florida.

Using radioactive dye and blue dye, gynecologic oncology surgeons are able to identify and remove just the sentinel nodes, which is the first place the cancer will go. The team of researchers was from Women & Infants Hospital of Rhode Island's Program in Women's Oncology and Division of Pathology and Laboratory Medicine, in Providence, Rhode Island.

"The object of this study was to examine the sentinel lymph node alone in women with squamous cell carcinoma of the vulva and evaluate their recurrence in the groin and any complication rates," explained Richard G. Moore, MD, of Women and Infants Hospital. "We discovered that removing just the sentinel node had decreased complication while maintaining a low rate of further occurrence of malignancy.

"This should be considered an option for women with squamous cell carcinoma of the vulva."

The study, the largest prospective trial on sentinel lymph node dissection among women with vulvar cancer in the United States, included 73 women with 69 undergoing sentinel node dissection. A total of 57 of those women were managed conservatively. Three experienced groin recurrences, for a recurrence rate of 5.2%.

Women whose sentinel node tested negative for metastasis were followed clinically without further treatment. Women with metastasis to the sentinel lymph node underwent full groin node dissection and were then followed by standard treatment protocols.

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