Intraoperative lymphatic mapping for vulvar cancer.
OBJECTIVE
To determine the feasibility of intraoperative lymphatic mapping in patients with vulvar cancer.


METHODS
Isosulfan blue was injected intradermally at the junction of tumor and normal skin in nine patients. We then attempted to identify the dye in the superficial lymphatic channels and in a superficial groin lymph node.


RESULTS
The sentinel node was identified in seven of 12 groins in seven of the nine subjects studied. Six of the successful cases had unilateral lesions. The cases in which a sentinel node was not identified were both patients with midline lesions, including one whose scar was injected following a prior wide local excision of a perineal tumor and one who appeared to have direct drainage to the deep pelvic nodes. There were no technique-related complications. In no case was there a positive non-sentinel node in the presence of a negative sentinel node.


CONCLUSIONS
Intraoperative lymphatic mapping is technically feasible in patients with vulvar cancer, particularly those with unilateral disease. Further experience is needed to evaluate the reliability of the technique in identification of groin node metastases.
Levenback
C
C
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston.
Burke
T W
TW
Gershenson
D M
DM
Morris
M
M
Malpica
A
A
Ross
M I
MI
D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D005260:Female; D006119:Groin; D006801:Humans; D007271:Injections, Intradermal; D007430:Intraoperative Care; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D010865:Pilot Projects; D012394:Rosaniline Dyes; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery*
D012394:Rosaniline Dyes; C025484:iso-sulfan blue