title: Update on sentinel lymph node biopsy for early-stage vulvar cancer.
abstract: Two prospective, multicenter clinical trials have demonstrated the feasibility and reproducibility of sentinel lymph node (SLN) biopsy as part of the standard management of early-stage vulvar carcinoma. On the basis of the results of these trials, many gynecologic oncologists have incorporated SLN biopsy for vulvar cancer into their practice. Studies have further shown that SLN biopsy is associated with better quality of life than full lymphadenectomy, is more cost-effective than full lymphadenectomy, and improved pathologic evaluation. A large observational study is currently evaluating the outcomes of patients with early-stage vulvar cancer according to the results of their SLN biopsy and the approach to their care; this study may confirm that full inguinofemoral lymphadenectomy is no longer necessary in most patients with this disease. Here, we review the published data supporting SLN biopsy as part of the standard of care for women with early-stage vulvar cancer and discuss future considerations for the management of this disease.
authors.affiliation: Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, United States. Electronic address: bslomovitz@med.miami.edu.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Slomovitz
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Coleman
authors.affiliation: Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Maaike H M
authors.initials: MH
authors.lastname: Oonk
authors.affiliation: Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Ate
authors.initials: A
authors.lastname: van der Zee
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: Charles
authors.initials: C
authors.lastname: Levenback
mesh_terms: D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014846:Vulvar Neoplasms / Q000473:pathology*
keywords: Lymphoscintigraphy; Sentinel lymph node biopsy; Ultrastaging; Vulvar cancer