Utilization and Outcomes of Sentinel Lymph Node Biopsy for Vulvar Cancer.
To examine the use and predictors of sentinel node biopsy in women with vulvar cancer.



The Perspective database, an all-payer database that collects data from more than 500 hospitals, was used to perform a retrospective cohort study of women with vulvar cancer who underwent vulvectomy and lymph node assessment from 2006 to 2015. Multivariable models were used to determine factors associated with sentinel node biopsy. Length of stay and cost were compared between women who underwent sentinel node biopsy and lymphadenectomy.



Among 2,273 women, sentinel node biopsy was utilized in 618 (27.2%) and 1,655 (72.8%) underwent inguinofemoral lymphadenectomy. Performance of sentinel node biopsy increased from 17.0% (95% confidence interval [CI] 12.0-22.0%) in 2006 to 39.1% (95% CI 27.1-51.0%) in 2015. In a multivariable model, women treated more recently were more likely to have undergone sentinel node biopsy, whereas women with more comorbidities and those treated at rural hospitals were less likely to have undergone the procedure. The median length of stay was shorter for those undergoing sentinel node biopsy (median 2 days, interquartile range 1-3) compared with women who underwent inguinofemoral lymphadenectomy (median 3 days, interquartile range 2-4). The cost of sentinel node biopsy was $7,599 (interquartile range $5,739-9,922) compared with $8,095 (interquartile range $5,917-11,281) for lymphadenectomy.



The use of sentinel node biopsy for vulvar cancer has more than doubled since 2006. Sentinel lymph node biopsy is associated with a shorter hospital stay and decreased cost compared with inguinofemoral lymphadenectomy.
Departments of Obstetrics and Gynecology and Medicine and the Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, the Department of Epidemiology, Mailman School of Public Health, Columbia University, the Department of Urology, Weill Cornell Medical College, and New York Presbyterian Hospital, New York, New York.
Stephanie
S
Cham
Ling
L
Chen
William M
WM
Burke
June Y
JY
Hou
Ana I
AI
Tergas
Jim C
JC
Hu
Cande V
CV
Ananth
Alfred I
AI
Neugut
Dawn L
DL
Hershman
Jason D
JD
Wright
D000328:Adult; D000368:Aged; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007264:Inguinal Canal; D007902:Length of Stay; D008197:Lymph Node Excision / Q000191:economics; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery*