title: Lymphatic mapping of sentinel nodes in early vulvar cancer.
abstract: OBJECTIVE
  The aim of the study was to determine the diagnostic accuracy and feasibility of sentinel lymph node (SLN) detection using a gamma probe in patients suffering from vulvar cancer.
  
  
  METHODS
  From May 1998 to November 2000, 26 patients with early vulvar cancer, planned for local wide excision or vulvectomy including groin dissection, were eligible for the study. Two to 3 h before the planned procedure we injected technetium(99) m-labeled microcolloid intradermally at four locations around the tumor. Dynamic and static images were recorded using a gamma camera. SLN locations were marked on the overlying skin. In the operating theater SLNs were identified at the beginning of the procedure using a handheld gamma-detection probe. After resection of suspected SLNs a standard unilateral or bilateral groin dissection was performed, subsequently followed by local wide excision or, if indicated, radical vulvectomy. Sentinel node detection using technetium(99) m-labeled microcolloid was compared with final histopathological and immunohistochemical results.
  
  
  RESULTS
  Scintigraphy showed focal uptake in all 26 patients. Intraoperatively we detected all sentinel nodes by handheld gamma probe. In 20 patients, one sentinel node was identified unilaterally, while in 6 patients two or more nodes were identified bilaterally. Histologically positive SLNs were found in 9 patients. In our preliminary series we did not find any false-negative SLN.
  
  
  CONCLUSIONS
  Identification of sentinel nodes in vulvar cancer is feasible with preoperatively administered technetium(99)m-labeled microcolloid. We confirm the results of previous studies and improve the evidence that the SLN procedure could be implemented in future therapy concepts.
authors.affiliation: Department of Gynecology, University of Vienna, Vienna, A-1090, Austria. gerhard.sliutz@akh-wien.ac.at
authors.forename: G
authors.initials: G
authors.lastname: Sliutz
authors.forename: A
authors.initials: A
authors.lastname: Reinthaller
authors.forename: T
authors.initials: T
authors.lastname: Lantzsch
authors.forename: T
authors.initials: T
authors.lastname: Mende
authors.forename: H
authors.initials: H
authors.lastname: Sinzinger
authors.forename: C
authors.initials: C
authors.lastname: Kainz
authors.forename: H
authors.initials: H
authors.lastname: Koelbl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D003102:Colloids / Q000008:administration & dosage / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013667:Technetium / Q000493:pharmacokinetics; D014846:Vulvar Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology
chemical_list: D003102:Colloids; D019275:Radiopharmaceuticals; D013667:Technetium