title: Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey.
abstract: OBJECTIVE
  To explore the accuracy of sentinel lymph node (SLN) dissection in predicting regional lymph node status by using either only Technetium-99m-labelled (Tc-99m) or in combination with a blue dye in patients with squamous cell cancer of vulva.
  
  
  METHODS
  Twenty-one patients who had T1 (≤2 cm) or T2 (>2cm) tumors that did not encroach into the urethra, vagina or anus were included in the study. For the first twelve patients, Tc-99m was used for SLN identification, and the combined technique was used in subsequent patients. Preoperatively, Tc-99m and a blue dye was injected intradermally around the tumor. Following SLN dissection, complete inguinofemoral lymphadenectomy was performed.
  
  
  RESULTS
  We could detect SLN in all 21 patients (100%) by either Tc-99m or the combined method. SLN was found to be histopathologically negative in 13 groins via Tc-99m and 10 groins via the combined method. Twenty-one of these 23 (91.3%) groin non-SLN were also negative, but in two groins, we detected metastatic non-SLN.
  
  
  CONCLUSIONS
  Although SLN dissection appears promising in vulvar cancer, false negative cases are reported in the literature. Sentinel lymph node dissection without complete lymphadenectomy does not seem appropriate for routine clinical use, since it is known that groin metastasis is fatal.
authors.affiliation: Department of Oncology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Nurettin
authors.initials: N
authors.lastname: Boran
authors.affiliation: Department of Oncology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Derya Akdağ
authors.initials: DA
authors.lastname: Cırık
authors.affiliation: Department of Pathology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Işıkdoğan
authors.affiliation: Department of Nuclear Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Kır
authors.affiliation: Department of Oncology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Turan
authors.affiliation: Department of Oncology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Tulunay
authors.affiliation: Department of Oncology, Etlik Zübeyde Hanım Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Faruk
authors.initials: MF
authors.lastname: Köse
keywords: Sentinel node; lymph node; vulvar cancer