title: Long-term follow-up of vulvar cancer patients evaluated with sentinel lymph node biopsy alone.
abstract: OBJECTIVE
  The objective of this study was to examine SLN evaluation alone in women with squamous cell carcinoma (SCC) of the vulva and evaluate the inguinal recurrence and complication rates.
  
  
  METHODS
  An IRB approved prospective study enrolled patients with SCC of the vulva. Peritumoral injection of Tc-99 sulfur colloid and blue dye was used to identify SLNs intraoperatively. Patients with negative SLN for metastasis were followed clinically without further treatment. Patients with metastasis to a SLN underwent full groin node dissection followed by standard treatment protocols.
  
  
  RESULTS
  A total of 73 women were enrolled onto protocol with 69 patients undergoing SLN dissection. Mean age was 66.9years (range: 29-91) with 47 stage I, 12 stage II, 9 stage III, 2 stage IV and 3 unstaged patients. SLN dissections were successful in 63 patients. Of the 111 groins evaluated with a SLN dissection 93% had a SLN identified with an average of 2 SLN per groin. There were 92 groins with negative SLN and 11 groins with positive SLN. 57 patients had negative SLN and underwent conservative management with the median follow-up of 58.3months. Three patients experienced groin recurrences (2 unilateral, 1 bilateral) for a recurrence rate of 5.2% (3/57). The complication rate for the inguinal incisions was 17.5% (1 cellulitis, 1 abscess, 2 lymphoceles, 5 lymphedema and leg pain).
  
  
  CONCLUSIONS
  Isolated SLN dissection alone has a low inguinal recurrence rate with decreased complications and should be considered as an option for women with SCC of the vulva.
authors.affiliation: Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA. Electronic address: krobison@wihri.org.
authors.forename: Katina
authors.initials: K
authors.lastname: Robison
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of North Carolina at Chapel Hill, Campus Box 7572, Chapel Hill, NC 27599-7572, USA.
authors.forename: Dario
authors.initials: D
authors.lastname: Roque
authors.affiliation: Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: McCourt
authors.affiliation: Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Stuckey
authors.affiliation: Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: DiSilvestro
authors.affiliation: Department of Pathology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: C James
authors.initials: CJ
authors.lastname: Sung
authors.affiliation: Department of Pathology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Steinhoff
authors.affiliation: Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: C O
authors.initials: CO
authors.lastname: Granai
authors.affiliation: Department of Obstetrics and Gynecology, Program in Women's Oncology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, 101 Dudley Street, Providence, RI, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Moore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D007866:Leg; D008137:Longitudinal Studies; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008209:Lymphedema; D008210:Lymphocele; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D013530:Surgical Wound Infection; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Complications; Inguinal recurrence rates; Sentinel lymph node biopsy; Vulvar cancer