title: Lymphatic mapping and sentinel lymph node biopsy in women with squamous cell carcinoma of the vulva: a gynecologic oncology group study.
abstract: OBJECTIVE
  To determine the safety of sentinel lymph node biopsy as a replacement for inguinal femoral lymphadenectomy in selected women with vulvar cancer.
  
  
  METHODS
  Eligible women had squamous cell carcinoma, at least 1-mm invasion, and tumor size ≥ 2 cm and ≤ 6 cm. The primary tumor was limited to the vulva, and there were no groin lymph nodes that were clinically suggestive of cancer. All women underwent intraoperative lymphatic mapping, sentinel lymph node biopsy, and inguinal femoral lymphadenectomy. Histologic ultra staging of the sentinel lymph node was prescribed.
  
  
  RESULTS
  In all, 452 women underwent the planned procedures, and 418 had at least one sentinel lymph node identified. There were 132 node-positive women, including 11 (8.3%) with false-negative nodes. Twenty-three percent of the true-positive patients were detected by immunohistochemical analysis of the sentinel lymph node. The sensitivity was 91.7% (90% lower confidence bound, 86.7%) and the false-negative predictive value (1-negative predictive value) was 3.7% (90% upper confidence bound, 6.1%). In women with tumor less than 4 cm, the false-negative predictive value was 2.0% (90% upper confidence bound, 4.5%).
  
  
  CONCLUSIONS
  Sentinel lymph node biopsy is a reasonable alternative to inguinal femoral lymphadenectomy in selected women with squamous cell carcinoma of the vulva.
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 440, Houston, TX 77030, USA. clevenba@mdanderson.org
authors: Charles F
authors: CF
authors: Levenback
authors: Shamshad
authors: S
authors: Ali
authors: Robert L
authors: RL
authors: Coleman
authors: Michael A
authors: MA
authors: Gold
authors: Jeffrey M
authors: JM
authors: Fowler
authors: Patricia L
authors: PL
authors: Judson
authors: Maria C
authors: MC
authors: Bell
authors: Koen
authors: K
authors: De Geest
authors: Nick M
authors: NM
authors: Spirtos
authors: Ronald K
authors: RK
authors: Potkul
authors: Mario M
authors: MM
authors: Leitao
authors: Jamie N
authors: JN
authors: Bakkum-Gamez
authors: Emma C
authors: EC
authors: Rossi
authors: Samuel S
authors: SS
authors: Lentz
authors: James J
authors: JJ
authors: Burke
authors: Linda
authors: L
authors: Van Le
authors: Cornelia L
authors: CL
authors: Trimble
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006119:Groin / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery*