Less invasive technique possible in vulvar cancer treatment

A team of researchers from Women & Infants Hospital of Rhode Island commanded a national stage to present the results of a study evaluating the use of sentinel lymph node dissection in women with vulvar malignancies, and then follow the patients for complications and recurrence.

The team – Drs. Richard G. Moore, Dario Roque, Carolyn McCourt, Ashley Stuckey, Paul A. DiSIlvestro, James Sung, Margaret Steinhoff, Cornelius Granai III, and Katina Robison – presented their work at the annual meeting of the Society of Gynecologic Oncologists (SGO) in Tampa. The oral presentation was part of the main plenary session at the meeting.

The study is entitled "Isolated sentinel lymph node biopsy with conservative management in women diagnosed with vulvar cancer." Using radioactive dye and blue dye, gynecologic oncology surgeons are able to identify and remove just the sentinel nodes, which is the first place cancer will go.

"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," Dr. Moore explains. "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. Fifty seven of those women were managed conservatively. Three experienced groin recurrences, for a recurrence rate of 5.2 percent.

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.