Vulvar Cancer

14,000,000 Leading Edge Experts on the ideXlab platform

Scan Science and Technology

Contact Leading Edge Experts & Companies

Scan Science and Technology

Contact Leading Edge Experts & Companies

The Experts below are selected from a list of 4047 Experts worldwide ranked by ideXlab platform

Katja N. Gaarenstroom - One of the best experts on this subject based on the ideXlab platform.

  • radiotherapy versus inguinofemoral lymphadenectomy as treatment for Vulvar Cancer patients with micrometastases in the sentinel node results of groinss v ii
    Journal of Clinical Oncology, 2021
    Co-Authors: Maaike H.m. Oonk, J.a. De Hullu, Ignace Vergote, Katja N. Gaarenstroom, Peter Baldwin, Brian Slomovitz, Helena C Van Doorn, Jacobus Van Der Velden, Brigitte F M Slangen, Mats Brannstrom
    Abstract:

    PURPOSEThe Groningen International Study on Sentinel nodes in Vulvar Cancer (GROINSS-V)-II investigated whether inguinofemoral radiotherapy is a safe alternative to inguinofemoral lymphadenectomy (...

  • sentinel nodes in Vulvar Cancer long term follow up of the groningen international study on sentinel nodes in Vulvar Cancer groinss v i
    Obstetrical & Gynecological Survey, 2016
    Co-Authors: Te Nienke Grootenhuis, Ignace Vergote, Katja N. Gaarenstroom, Eleonore B Van Dorst, Van Der Ate Zee, H C Van Doorn, J Van Der Velden, Vanna Zanagnolo, Peter J Baldwin, J W Trum
    Abstract:

    Obstet Gynecol Surv 2016;71(3):157-159 Treatment for early-stage Vulvar Cancer used to consist of wide local excision of the tumor combined with an inguinofemoral lymphadenectomy. This treatment is effective but has a high morbidity rate.

  • sentinel nodes in Vulvar Cancer long term follow up of the groningen international study on sentinel nodes in Vulvar Cancer groinss v i
    Gynecologic Oncology, 2016
    Co-Authors: Te Nienke Grootenhuis, Ignace Vergote, Katja N. Gaarenstroom, Eleonore B Van Dorst, Van Der Ate Zee, H C Van Doorn, J Van Der Velden, Vanna Zanagnolo, Peter J Baldwin, J W Trum
    Abstract:

    Abstract Objective In 2008 GROINSS-V-I, the largest validation trial on the sentinel node (SN) procedure in Vulvar Cancer, showed that application of the SN-procedure in patients with early-stage Vulvar Cancer is safe. The current study aimed to evaluate long-term follow-up of these patients regarding recurrences and survival. Methods From 2000 until 2006 GROINSS-V-I included 377 patients with unifocal squamous cell carcinoma of the vulva (T1, Results The median follow-up was 105months (range 0–179). The overall local recurrence rate was 27.2% at 5years and 39.5% at 10years after primary treatment, while for SN-negative patients 24.6% and 36.4%, and for SN-positive patients 33.2% and 46.4% respectively (p=0.03). In 39/253 SN-negative patients (15.4%) an inguinofemoral lymphadenectomy was performed, because of a local recurrence. Isolated groin recurrence rate was 2.5% for SN-negative patients and 8.0% for SN-positive patients at 5years. Disease-specific 10-year survival was 91% for SN-negative patients compared to 65% for SN-positive patients (p Conclusions Survival is very good for patients with a negative SN, but still 36% of these patients, as well as 46% of the patients with a positive SN, will have a local recurrence. Although a local recurrence is treated with curative intent, the disease-specific survival of these patients decreases significantly.

  • sentinel lymph node biopsy in Vulvar Cancer using combined radioactive and fluorescence guidance
    International Journal of Gynecological Cancer, 2015
    Co-Authors: Floris P R Verbeek, Katja N. Gaarenstroom, A A W Peters, Boudewijn E Schaafsma, John V Frangioni, Cornelis J H Van De Velde, Quirijn R J G Tummers, D D D Rietbergen, Fijs W B Van Leeuwen, Alexander L Vahrmeijer
    Abstract:

    Objective Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has recently been introduced to improve the sentinel lymph node (SLN) procedure. Several optical tracers have been successfully tested. However, the optimal tracer formulation is still unknown. This study evaluates the performance of ICG–technetium-99m (99mTc)–nanocolloid in relation to 2 most commonly used ICG-based formulas during SLN biopsy in Vulvar Cancer. Methods and Materials Twelve women who planned to undergo SLN biopsy for stage I Vulvar Cancer were prospectively included. Sentinel lymph node mapping was performed using the dual-modality radioactive and NIR fluorescence tracer ICG–99mTc-nanocolloid. All patients underwent combined SLN localization using NIR fluorescence and the (current) gold standard using blue dye and radioactive guidance. Results In all 12 patients, at least 1 SLN was detected during surgery. A total of 21 lymph nodes (median 2; range, 1–3) were resected. Median time between skin incision and first SLN detection was 8 (range, 1–22) minutes. All resected SLNs were both radioactive and fluorescent, although only 13 (62%) of 21 SLNs stained blue. Median brightness of exposed SLNs, expressed as signal-to-background ratio, was 5.4 (range, 1.8–11.8). Lymph node metastases were found in 3 patients. Conclusions Near-infrared fluorescence-guided SLN mapping is feasible and outperforms blue dye staining. Premixing ICG with 99mTc-nanocolloid provides real-time intraoperative imaging of the SN and seems to be the optimal tracer combination in terms of intraoperative detection rate of the SN (100%). Moreover, ICG–99mTc-nanocolloid allows the administration of a 5-times lower injected dose of ICG (compared with ICG and ICG absorbed to human serum albumin) and can be injected up to 20 hours before surgery.

  • optimization of near infrared fluorescent sentinel lymph node mapping for Vulvar Cancer
    American Journal of Obstetrics and Gynecology, 2012
    Co-Authors: Merlijn Hutteman, Katja N. Gaarenstroom, Joost R Van Der Vorst, A A W Peters, Sven J D Mieog, Boudewijn E Schaafsma, Clemens W G M Lowik, John V Frangioni, Cornelis J H Van De Velde, Alexander L Vahrmeijer
    Abstract:

    Objectives Near-infrared fluorescence imaging has the potential to improve sentinel lymph node mapping in Vulvar Cancer, which was assessed in the current study. Furthermore, dose optimization of indocyanine green adsorbed to human serum albumin was performed. Study Design Nine Vulvar Cancer patients underwent the standard sentinel lymph node procedure using 99m technetium-nancolloid and patent blue. In addition, intraoperative imaging was performed after peritumoral injection of 1.6 mL of 500, 750, or 1000 μM of indocyanine green adsorbed to human serum albumin. Results Near-infrared fluorescence sentinel lymph node mapping was successful in all patients. A total of 14 sentinel lymph nodes (average, 1.6; range, 1–4) were detected: 14 radioactive (100%), 11 blue (79%), and 14 near-infrared fluorescent (100%). Conclusion This study demonstrates feasibility and accuracy of sentinel lymph node mapping using indocyanine green adsorbed to human serum albumin. Considering safety, cost, and pharmacy preferences, an indocyanine green adsorbed to human serum albumin concentration of 500 μM appears optimal for sentinel lymph node mapping in Vulvar Cancer.

J.a. De Hullu - One of the best experts on this subject based on the ideXlab platform.

  • radiotherapy versus inguinofemoral lymphadenectomy as treatment for Vulvar Cancer patients with micrometastases in the sentinel node results of groinss v ii
    Journal of Clinical Oncology, 2021
    Co-Authors: Maaike H.m. Oonk, J.a. De Hullu, Ignace Vergote, Katja N. Gaarenstroom, Peter Baldwin, Brian Slomovitz, Helena C Van Doorn, Jacobus Van Der Velden, Brigitte F M Slangen, Mats Brannstrom
    Abstract:

    PURPOSEThe Groningen International Study on Sentinel nodes in Vulvar Cancer (GROINSS-V)-II investigated whether inguinofemoral radiotherapy is a safe alternative to inguinofemoral lymphadenectomy (...

  • patients with usual Vulvar intraepithelial neoplasia related Vulvar Cancer have an increased risk of cervical abnormalities
    British Journal of Cancer, 2009
    Co-Authors: R.p. De ,bie, H P Van De Nieuwenhof, Ruud L M Bekkers, Willem J G Melchers, Albert G Siebers, Johan Bulten, Leon F A G Massuger, J.a. De Hullu
    Abstract:

    Patients with usual Vulvar intraepithelial neoplasia-related Vulvar Cancer have an increased risk of cervical abnormalities

  • sentinel node dissection is safe in the treatment of early stage Vulvar Cancer
    Journal of Clinical Oncology, 2008
    Co-Authors: Ate G J Van Der Zee, J.a. De Hullu, Anca C. Ansink, Maaike H.m. Oonk, Ignace Vergote, René H.m. Verheijen, Angelo Maggioni, Katja N. Gaarenstroom, P J Baldwin, Eleonore B Van Dorst
    Abstract:

    Purpose To investigate the safety and clinical utility of the sentinel node procedure in early-stage Vulvar Cancer patients. Patients and Methods A multicenter observational study on sentinel node detection using radioactive tracer and blue dye was performed in patients with T1/2 ( 4 cm) squamous cell Cancer of the vulva. When the sentinel node was found to be negative at pathologic ultrastaging, inguinofemoral lymphadenectomy was omitted, and the patient was observed with follow-up for 2 years at intervals of every 2 months. Stopping rules were defined for the occurrence of groin recurrences. Results From March 2000 until June 2006, a sentinel node procedure was performed in 623 groins of 403 assessable patients. In 259 patients with unifocal Vulvar disease and a negative sentinel node (median follow-up time, 35 months), six groin recurrences were diagnosed (2.3%; 95% CI, 0.6% to 5%), and 3-year survival rate was 97% (95% CI, 91% to 99%). Short-term morbidity was decreased in patients after sentinel node dissection only when compared with patients with a positive sentinel node who underwent inguinofemoral lymphadenectomy (wound breakdown in groin: 11.7% v 34.0%, respectively; P .0001; and cellulitis: 4.5% v 21.3%, respectively; P .0001). Long-term morbidity also was less frequently observed after removal of only the sentinel node compared with sentinel node removal and inguinofemoral lymphadenectomy (recurrent erysipelas: 0.4% v 16.2%, respectively; P .0001; and lymphedema of the legs: 1.9% v 25.2%, respectively; P .0001). Conclusion In early-stage Vulvar Cancer patients with a negative sentinel node, the groin recurrence rate is low, survival is excellent, and treatment-related morbidity is minimal. We suggest that sentinel node dissection, performed by a quality-controlled multidisciplinary team, should be part of the standard treatment in selected patients with early-stage Vulvar Cancer. J Clin Oncol 26:884-889. © 2008 by American Society of Clinical Oncology

  • Pitfalls in the sentinel lymph node procedure in Vulvar Cancer
    Gynecologic Oncology, 2004
    Co-Authors: J.a. De Hullu, Mhm Oonk, Anca C. Ansink, Harmen Hollema, Philip L. De Jager
    Abstract:

    OBJECTIVES: There is an increasing interest among gynecologic oncologists to implement the sentinel lymph node (SLN) procedure in Vulvar Cancer patients in clinical practice. However, the safety of this promising method of staging still has to be proven in a randomized trial. MATERIALS AND METHODS: Two Vulvar Cancer patients are reported to illustrate pitfalls in the sentinel lymph node procedure. RESULTS: The phenomena of bypassing the sentinel lymph node and confusion about the number of removed sentinel lymph nodes are presented and discussed. CONCLUSION: Gynecological oncologists who perform the sentinel lymph node procedure in Vulvar Cancer patients should perform this technique by following a strict protocol and within the protection of a clinical trial.

Alexander L Vahrmeijer - One of the best experts on this subject based on the ideXlab platform.

  • sentinel lymph node biopsy in Vulvar Cancer using combined radioactive and fluorescence guidance
    International Journal of Gynecological Cancer, 2015
    Co-Authors: Floris P R Verbeek, Katja N. Gaarenstroom, A A W Peters, Boudewijn E Schaafsma, John V Frangioni, Cornelis J H Van De Velde, Quirijn R J G Tummers, D D D Rietbergen, Fijs W B Van Leeuwen, Alexander L Vahrmeijer
    Abstract:

    Objective Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has recently been introduced to improve the sentinel lymph node (SLN) procedure. Several optical tracers have been successfully tested. However, the optimal tracer formulation is still unknown. This study evaluates the performance of ICG–technetium-99m (99mTc)–nanocolloid in relation to 2 most commonly used ICG-based formulas during SLN biopsy in Vulvar Cancer. Methods and Materials Twelve women who planned to undergo SLN biopsy for stage I Vulvar Cancer were prospectively included. Sentinel lymph node mapping was performed using the dual-modality radioactive and NIR fluorescence tracer ICG–99mTc-nanocolloid. All patients underwent combined SLN localization using NIR fluorescence and the (current) gold standard using blue dye and radioactive guidance. Results In all 12 patients, at least 1 SLN was detected during surgery. A total of 21 lymph nodes (median 2; range, 1–3) were resected. Median time between skin incision and first SLN detection was 8 (range, 1–22) minutes. All resected SLNs were both radioactive and fluorescent, although only 13 (62%) of 21 SLNs stained blue. Median brightness of exposed SLNs, expressed as signal-to-background ratio, was 5.4 (range, 1.8–11.8). Lymph node metastases were found in 3 patients. Conclusions Near-infrared fluorescence-guided SLN mapping is feasible and outperforms blue dye staining. Premixing ICG with 99mTc-nanocolloid provides real-time intraoperative imaging of the SN and seems to be the optimal tracer combination in terms of intraoperative detection rate of the SN (100%). Moreover, ICG–99mTc-nanocolloid allows the administration of a 5-times lower injected dose of ICG (compared with ICG and ICG absorbed to human serum albumin) and can be injected up to 20 hours before surgery.

  • near infrared fluorescence sentinel lymph node biopsy in Vulvar Cancer a randomised comparison of lymphatic tracers
    British Journal of Obstetrics and Gynaecology, 2013
    Co-Authors: Boudewijn E Schaafsma, Joost R Van Der Vorst, A A W Peters, John V Frangioni, Fpr Verbeek, C D De Kroon, Mie Van Poelgeest, Jbmz Trimbos, Cjh Van De Velde, Alexander L Vahrmeijer
    Abstract:

    This study aims to confirm the feasibility of near-infrared (NIR) fluorescence imaging for sentinel lymph node (SLN) biopsy in Vulvar Cancer and to compare the tracer indocyanine green (ICG) bound to human serum albumin (HSA) versus ICG alone. Women received 99mTc-nanocolloid and patent blue for SLN detection. Subsequently, women randomly received ICG:HSA or ICG alone. In 24 women, 35 SLNs were intraoperatively detected. All SLNs detected were radioactive and NIR fluorescent and 27 (77%) were blue. No significant difference was found between ICG:HSA and ICG alone. This trial confirms the feasibility of NIR fluorescence imaging for SLN mapping in Vulvar Cancer.

  • optimization of near infrared fluorescent sentinel lymph node mapping for Vulvar Cancer
    American Journal of Obstetrics and Gynecology, 2012
    Co-Authors: Merlijn Hutteman, Katja N. Gaarenstroom, Joost R Van Der Vorst, A A W Peters, Sven J D Mieog, Boudewijn E Schaafsma, Clemens W G M Lowik, John V Frangioni, Cornelis J H Van De Velde, Alexander L Vahrmeijer
    Abstract:

    Objectives Near-infrared fluorescence imaging has the potential to improve sentinel lymph node mapping in Vulvar Cancer, which was assessed in the current study. Furthermore, dose optimization of indocyanine green adsorbed to human serum albumin was performed. Study Design Nine Vulvar Cancer patients underwent the standard sentinel lymph node procedure using 99m technetium-nancolloid and patent blue. In addition, intraoperative imaging was performed after peritumoral injection of 1.6 mL of 500, 750, or 1000 μM of indocyanine green adsorbed to human serum albumin. Results Near-infrared fluorescence sentinel lymph node mapping was successful in all patients. A total of 14 sentinel lymph nodes (average, 1.6; range, 1–4) were detected: 14 radioactive (100%), 11 blue (79%), and 14 near-infrared fluorescent (100%). Conclusion This study demonstrates feasibility and accuracy of sentinel lymph node mapping using indocyanine green adsorbed to human serum albumin. Considering safety, cost, and pharmacy preferences, an indocyanine green adsorbed to human serum albumin concentration of 500 μM appears optimal for sentinel lymph node mapping in Vulvar Cancer.

Peter Hillemanns - One of the best experts on this subject based on the ideXlab platform.

  • lymph node ratio in inguinal lymphadenectomy for squamous cell Vulvar Cancer results from the ago care 1 study
    Gynecologic Oncology, 2019
    Co-Authors: Stephan Polterauer, Peter Hillemanns, Richard Schwameis, Christoph Grimm, Jalid Sehouli, F Hilpert, Nikolaus De Gregorio, Annette Hasenburg, J Juckstock, Sophie Theresa Furst
    Abstract:

    Abstract Objective Lymph node ratio (LNR) can predict treatment outcome and prognosis in patients with solid tumors. Aim of the present analysis was to confirm the concept of using LNR for assessing outcome in patients with Vulvar Cancer after surgery with inguinal lymphadenectomy in a large multicenter project. Methods The AGO-CaRE-1 study multicenter database was used for analysis. LNR was defined as ratio of number of positive lymph nodes (LN) to the number of resected. Previously established LNR risk groups were used to stratify patients. LNR was investigated with respect to clinical parameters. Univariate and multivariable survival analyses were performed to assess the value of LNR in order to predict overall (OS) and progression-free (PFS) survival. Results In total, 1047 patients treated with surgery including inguinal lymph node resection for squamous cell carcinoma of the vulva were identified from the database. Of these, 370 (35.3%) were found to have positive inguinal LN. In total, 677 (64.7%) had a LNR of 0% (N0), 255 (24.4%) a LNR of >0%  0%  Conclusions In women with Vulvar Cancer LNR appears to be a consistent, independent prognostic parameter for both PFS and OS and allows patient stratification into three distinct risk groups. In survival analyses, LNR outperformed nodal status and number of positive nodes.

  • groin recurrences in node negative Vulvar Cancer patients after sole sentinel lymph node dissection
    International Journal of Gynecological Cancer, 2017
    Co-Authors: Rudiger Klapdor, H Hertel, Philipp Soergel, Peter Hillemanns
    Abstract:

    Objective This study aimed to evaluate the recurrence rates after sole sentinel dissection in Vulvar Cancer and describe characteristics of groin recurrences. Methods All Vulvar Cancer cases between 2008 and 2014 were reviewed. Inclusion criteria were restricted to lymph node–negative patients, sole sentinel lymph node dissection (SLND), and tumor diameter less than 4 cm. In all patients, Tc-99m nanocolloid was used for preoperative SLN imaging. Regularly, planar lymphoscintigraphy and single-photon emission computed tomography with computed tomography were performed. Ultrastaging was routinely conducted on all negative lymph nodes. Results Of 140 Vulvar Cancer cases, 30 node-negative patients underwent sole SLND and met inclusion criteria. Keratinizing squamous cell carcinoma was determined in final histology in 20/30 (66.7%) patients and the mainly diagnosed tumor stage was pT1b (21/30, 70%). Three perioperative complications occurred. On average, 4.6 (1–9) SLNs were dissected per patient and 2.5 (1–6) per each groin, respectively. During a median follow-up of 43.5 (4–75) months, 5/30 (16.7%; 95% confidence interval, 7.3%–33.6%) local recurrences occurred. In addition, 2/30 (6.6%; 95% confidence interval, 1.9%–21.3%) groin recurrences were identified within a period of 12 months after the primary surgery. Both patients had large (>2 cm) midline tumors. Despite surgical as well as adjuvant treatment of the recurrent disease, both patients with groin recurrences died. Conclusions Sentinel lymph node dissection is a safe and feasible alternative in early Vulvar Cancer. But false-negative sentinel carry a high risk of mostly fatal groin recurrences. Especially, midline tumors larger than 2 cm have to be treated with caution, because they are mostly found in cases with groin recurrences after sole SLND.

  • adjuvant therapy in lymph node positive Vulvar Cancer the ago care 1 study
    Journal of the National Cancer Institute, 2015
    Co-Authors: Sven Mahner, Jalid Sehouli, J Jueckstock, F Hilpert, Petra Neuser, P Harter, Nikolaus De Gregorio, Annette Hasenburg, Annika Habermann, Peter Hillemanns
    Abstract:

    Background: Women with node-positive Vulvar Cancer have a high risk for disease recurrence. Indication criteria for adjuvant radiotherapy are controversial. This study was designed to further understand the role of adjuvant therapy in node-positive disease. Methods: Patients with primary squamous-cell Vulvar Cancer treated at 29 gynecologic Cancer centers in Germany from 1998 through 2008 were included in this retrospective exploratory multicenter cohort study. Of 1618 documented patients, 1249 had surgical groin staging and known lymph node status and were further analyzed. All statistical tests were two-sided. Results: Four hundred forty-seven of 1249 patients (35.8%) had lymph node metastases (N+). The majority of N+ patients had one (172 [38.5%]) or two (102 [22.8%]) positive nodes. The three-year progression-free survival (PFS) rate of N+ patients was 35.2%, and the overall survival (OS) rate 56.2% compared with 75.2% and 90.2% in node-negative patients (N-). Two hundred forty-four (54.6%) N+ patients had adjuvant therapy, of which 183 (40.9%) had radiotherapy directed at the groins (+/-other fields). Three-year PFS and OS rates in these patients were better compared with N+ patients without adjuvant treatment (PFS: 39.6% vs 25.9%, hazard ratio [HR] = 0.67, 95% confidence interval [CI[= 0.51 to 0.88, P = .004; OS: 57.7% vs 51.4%, HR = 0.79, 95% CI = 0.56 to 1.11, P = .17). This effect was statistically significant in multivariable analysis adjusted for age, Eastern Cooperative Oncology Group, Union internationale contre le Cancer stage, grade, invasion depth, and number of positive nodes (PFS: HR = 0.58, 95% CI = 0.43 to 0.78, P < .001; OS: HR = 0.63, 95% CI = 0.43 to 0.91, P = .01). Conclusion: This large multicenter study in Vulvar Cancer observed that adjuvant radiotherapy was associated with improved prognosis in node-positive patients and will hopefully help to overcome concerns regarding adjuvant treatment. However, outcome after adjuvant radiotherapy remains poor compared with node-negative patients. Adjuvant chemoradiation could be a possible strategy to improve therapy because it is superior to radiotherapy alone in other squamous cell carcinomas.

Maaike H.m. Oonk - One of the best experts on this subject based on the ideXlab platform.

  • radiotherapy versus inguinofemoral lymphadenectomy as treatment for Vulvar Cancer patients with micrometastases in the sentinel node results of groinss v ii
    Journal of Clinical Oncology, 2021
    Co-Authors: Maaike H.m. Oonk, J.a. De Hullu, Ignace Vergote, Katja N. Gaarenstroom, Peter Baldwin, Brian Slomovitz, Helena C Van Doorn, Jacobus Van Der Velden, Brigitte F M Slangen, Mats Brannstrom
    Abstract:

    PURPOSEThe Groningen International Study on Sentinel nodes in Vulvar Cancer (GROINSS-V)-II investigated whether inguinofemoral radiotherapy is a safe alternative to inguinofemoral lymphadenectomy (...

  • european society of gynaecological oncology guidelines for the management of patients with Vulvar Cancer
    International Journal of Gynecological Cancer, 2017
    Co-Authors: Maaike H.m. Oonk, Sven Mahner, Francois Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brannstrom, Fabio Landoni, Umesh Mahantshetty, Mansoor Raza Mirza, Cordula Petersen
    Abstract:

    Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic Cancers across Europe. Methods The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with Vulvar Cancer and have demonstrated leadership and interest in the management of patients with Vulvar Cancer (18 experts across Europe). To ensure that the statements are evidence based, the current literature identified from a systematic search has been reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group (expert agreement). The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 181 international reviewers including patient representatives independent from the development group. Results The guidelines cover diagnosis and referral, preoperative investigations, surgical management (local treatment, groin treatment including sentinel lymph node procedure, reconstructive surgery), radiation therapy, chemoradiation, systemic treatment, treatment of recurrent disease (Vulvar recurrence, groin recurrence, distant metastases), and follow-up.

  • update on sentinel lymph node biopsy for early stage Vulvar Cancer
    Gynecologic Oncology, 2015
    Co-Authors: Brian M Slomovitz, Maaike H.m. Oonk, Ate G J Van Der Zee, Robert L Coleman, Charles F Levenback
    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.

  • sentinel node dissection is safe in the treatment of early stage Vulvar Cancer
    Journal of Clinical Oncology, 2008
    Co-Authors: Ate G J Van Der Zee, J.a. De Hullu, Anca C. Ansink, Maaike H.m. Oonk, Ignace Vergote, René H.m. Verheijen, Angelo Maggioni, Katja N. Gaarenstroom, P J Baldwin, Eleonore B Van Dorst
    Abstract:

    Purpose To investigate the safety and clinical utility of the sentinel node procedure in early-stage Vulvar Cancer patients. Patients and Methods A multicenter observational study on sentinel node detection using radioactive tracer and blue dye was performed in patients with T1/2 ( 4 cm) squamous cell Cancer of the vulva. When the sentinel node was found to be negative at pathologic ultrastaging, inguinofemoral lymphadenectomy was omitted, and the patient was observed with follow-up for 2 years at intervals of every 2 months. Stopping rules were defined for the occurrence of groin recurrences. Results From March 2000 until June 2006, a sentinel node procedure was performed in 623 groins of 403 assessable patients. In 259 patients with unifocal Vulvar disease and a negative sentinel node (median follow-up time, 35 months), six groin recurrences were diagnosed (2.3%; 95% CI, 0.6% to 5%), and 3-year survival rate was 97% (95% CI, 91% to 99%). Short-term morbidity was decreased in patients after sentinel node dissection only when compared with patients with a positive sentinel node who underwent inguinofemoral lymphadenectomy (wound breakdown in groin: 11.7% v 34.0%, respectively; P .0001; and cellulitis: 4.5% v 21.3%, respectively; P .0001). Long-term morbidity also was less frequently observed after removal of only the sentinel node compared with sentinel node removal and inguinofemoral lymphadenectomy (recurrent erysipelas: 0.4% v 16.2%, respectively; P .0001; and lymphedema of the legs: 1.9% v 25.2%, respectively; P .0001). Conclusion In early-stage Vulvar Cancer patients with a negative sentinel node, the groin recurrence rate is low, survival is excellent, and treatment-related morbidity is minimal. We suggest that sentinel node dissection, performed by a quality-controlled multidisciplinary team, should be part of the standard treatment in selected patients with early-stage Vulvar Cancer. J Clin Oncol 26:884-889. © 2008 by American Society of Clinical Oncology

Related terms

Vulvar Cancer - 15 days free trial to Access Experts & Abstracts