title: Detection and credibility of sentinel node in vulvar cancer: a single institutional study and short review of literature.
abstract: OBJECTIVE
  To evaluate the detectability and credibility of sentinel lymph node (SLN) in vulvar cancer.
  
  
  METHODS
  With Tc99m-nanocolloid and methylene blue, we identified SLNs in 34 patients. In 27 cases both tracers were used, while in 7 only blue dye was used. Completion lymphadenectomy was performed in all patients. SLNs and non-SLNs were sent separately for pathologic evaluation.
  
  
  RESULTS
  At least one SLN was identified in all patients. Detection rate per groin was not significantly higher in the combined versus blue dye only technique (42/50 vs. 10/14, p = 0.43). 99m-Tc was not superior to blue dye in detecting SLN (42/50 vs. 50/64, p = 0.65). Midline location of the tumor did not seem to negatively affect the procedure. Four false negatives were observed in three patients with tumors >4 cm. Negative predictive value of SLN was 100% for grade I tumors ≤ 4 cm in patients ≤ 71 years.
  
  
  CONCLUSIONS
  Tc-99m does not seem to be superior to methylene blue in the detection of SLN in vulvar cancer. Patients of younger age with small, well-differentiated tumors appear to be the most suitable candidates for lymphatic mapping.
authors.affiliation: Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, 9, Antheon str, 14235 Athens, Greece. nakrivos@hotmail.com
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Akrivos
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
authors.forename: George
authors.initials: G
authors.lastname: Vlachos
authors.forename: Maria
authors.initials: M
authors.lastname: Sotiropoulou
authors.forename: Vasileios
authors.initials: V
authors.lastname: Papantoniou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Biliatis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Haidopoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomakos
authors.forename: Maria
authors.initials: M
authors.lastname: Simou
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000601:surgery; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008751:Methylene Blue; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid; D014846:Vulvar Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery
chemical_list: D013671:Technetium Tc 99m Sulfur Colloid; D008751:Methylene Blue