scholarly journals Indocyanine green fluorescence imaging, sentinel lymph node mapping in patients with vulvar cancer: peritumoral injection dosage and waiting times in our experience

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
P. Scollo ◽  
M. Ferrara ◽  
B. Pecorino ◽  
A. B. Di Stefano ◽  
G. Scibilia
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Vulvar Cancer ◽  
Maximum Diameter ◽  
Vulvar Squamous Cell Carcinoma

Abstract Background Vulvar cancer is a rare gynecological malignancy that primarily affects women of postmenopausal age. Treatment is mainly surgical, particularly for vulvar squamous cell carcinoma, the most prevalent histotype. In patients with unifocal tumors with a maximum diameter of <4 cm, in the absence of suspected inguinal lymph nodes, sentinel lymph node (SLN) biopsy is recommended. The use of a radioactive tracer is mandatory; the use of the vital blue dye is optional. Results Two patients diagnosed with vulvar squamous cell carcinoma (FIGO IB stage) underwent bilateral radical vulvectomy, SLN search and removal, and bilateral inguinal lymphadenectomy at the Cannizzaro Hospital Operative Unit of Obstetrics and Gynecology Department (Catania, Italy). Three milliliters of indocyanine green (ICG) 0.5 mg/mL was administered in 3 peritumoral injections under general anesthesia to screen the SLN. The images were acquired using an intraoperative infrared camera system, which allowed intraoperative visualization of the SLN. An SLN was identified for each patient. The lymph nodes examined by the pathologist were negative for metastatic localization of the disease. However, patients underwent bilateral inguinofemoral lymphadenectomy, as this procedure is not currently codified as a gold standard for the detection of SLN in vulvar cancer. All the lymph nodes removed were negative for the localization of vulvar carcinoma metastases. Conclusions The potential of the administration of indocyanine green (ICG) allows the execution of SLN biopsy, avoiding the multiple administrations of radiocolloid in the pre-operative phase, painful for the patient, elimination, and exposure to radioactivity. Therefore, while requiring standardization of the methodology and a large-scale application, this procedure could open a new surgical management perspective in patients with early-stage vulvar cancer.

Impact of partnership status on clinical outcomes of patients with vulvar squamous cell carcinoma and performance of sentinel lymph node biopsy

2020 ◽  
Vol 30 (5) ◽  
pp. 583-589 ◽  
Author(s):  
Albert Alhatem ◽  
W Clark Lambert ◽  
Katrice Karanfilian ◽  
Sara Behbahani ◽  
Debra Heller
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Lymph Node Biopsy ◽  
Vulvar Squamous Cell Carcinoma ◽  
Node Biopsy ◽  
Partnership Status

ObjectivesVulvar squamous cell carcinoma is a rare malignancy and lymph node involvement is the most significant prognostic factor. We aimed to evaluate the association between partnership status and mortality from vulvar squamous cell carcinoma, cancer stage at the time of presentation, and the decision for sentinel lymph node biopsy.MethodsThe US National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database was queried and different parameters were evaluated relative to partnership status. A total of 4851 patients with vulvar squamous cell carcinoma, >18 years of age, who presented between January 2010 to December 2015, were analyzed. Kaplan-Meier and Cox regression analyses were used to assess survival and hazard ratio. Multinomial regression analysis and χ2 were utilized to evaluate odd ratios and significance of variables.ResultsMost patients were unpartnered (58.5%), including never married (17.7%), divorced (13.8%), or widowed (27%). Partnered patients were mostly Caucasian (88.4%), insured (74%), and presented with stage I disease (57.2%), compared with unpartnered patients (79.1%), (61.7%), and (51.7%), respectively (p<0.01). The mean survival time (months) in partnered patients was longer, compared with unpartnered (p<0.001), and the difference between both groups increased from 9 months at stage I to 24 months at stage IV, which remained independently significant after adjusting the different variables. Cox regression showed that partnered patients had a lower hazard ratio than unpartnered patients (p<0.01). Mortality from vulvar squamous cell carcinoma increased with age at diagnosis, no surgery, and unemployment (p<0.01). Unpartnered patients were the least likely to undergo sentinel lymph node biopsy in early stages, compared with partnered (p<0.01). Univariate Cox regression analysis showed that not performing sentinel lymph node biopsy almost doubled the hazard ratio of vulvar squamous cell carcinoma (p<0.01).ConclusionsPartnership status should be considered when counseling patients for vulvar squamous cell carcinoma therapy and when recommending screening and follow-up to optimize patient care.

Repeat sentinel lymph node procedure in patients with recurrent vulvar squamous cell carcinoma is feasible

2016 ◽  
Vol 140 (3) ◽  
pp. 415-419 ◽  
Author(s):  
Helena C. van Doorn ◽  
Heleen J. van Beekhuizen ◽  
Katja N. Gaarenstroom ◽  
Jacobus van der Velden ◽  
Ate G.J. van der Zee ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Vulvar Squamous Cell Carcinoma ◽  
Sentinel Lymph Node Procedure

Further Data on the Usefulness of Sentinel Lymph Node Identification and Ultrastaging in Vulvar Squamous Cell Carcinoma

2003 ◽  
Vol 88 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Luis M. Puig-Tintoré ◽  
Jaume Ordi ◽  
Sergi Vidal-Sicart ◽  
José A Lejárcegui ◽  
Aureli Torné ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Vulvar Squamous Cell Carcinoma ◽  
Sentinel Lymph Node Identification

Role of Clinical Palpation in Evaluation of Cervical Lymph Node in Oral Squamous Cell Carcinoma

2013 ◽  
Vol 1 (2) ◽  
pp. 02-06
Author(s):  
SM Anwar Sadat ◽  
Sufia Nasrin Rita ◽  
Shoma Banik ◽  
Md Nazmul Hasan Khandker ◽  
Md Mahfuz Hossain ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Oral Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Value ◽  
Cervical Lymph Node ◽  
Betel Quid ◽  
Cervical Lymph Nodes

A cross sectional study of 29 cases of oral squamous cell carcinoma with or without  cervical lymph node metastasis was done among Bangladeshi patients from January 2006 to December 2007. Majority of the study subjects (34.5%) belonged to the age group of 40-49 years. 58.6% of the study subjects were male, while remaining 41.4% of them were female. 51.7% of the lesions were located in the alveolar ridge where the other common sites were buccal mucosa (27.6%) and retro molar area (13.8%). Half of the study subjects (51.7%) were habituated to betel quid chewing followed by 37.9% and 10.3% were habituated to smoking and betel quid-smoking respectively. Grade I lesions was most prevalent (75.9%) in the study subjects.  Majority of cases presented with Stage IV lesions (55.2%). The sensitivity, specificity, positive predictive value, negative predictive value & accuracy of clinical palpation method for determining metastatic cervical lymph nodes were 93.33%, 64.29%, 73.68%, 90% and 79.3% respectively. Careful and repeated clinical palpation plays important role in evaluation of cervical lymph nodes though several modern techniques may help additionally in the management of oral cancer.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13978 Update Dent. Coll. j. 2011: 1(2): 02-06

Validity of frozen section in sentinel lymph node biopsy for the staging in oral and oropharyngeal squamous cell carcinoma

2012 ◽  
Vol 106 (7) ◽  
pp. 816-819 ◽  
Author(s):  
Melanie S. Vorburger ◽  
Martina A. Broglie ◽  
Alex Soltermann ◽  
Stephan K. Haerle ◽  
Sarah R. Haile ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Frozen Section ◽  
Lymph Node Biopsy ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Node Biopsy
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