Serveur d'exploration sur le lymphœdème

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Groin lymph node detection and sentinel lymph node biopsy in vulvar cancer

Identifieur interne : 001030 ( Main/Exploration ); précédent : 001029; suivant : 001031

Groin lymph node detection and sentinel lymph node biopsy in vulvar cancer

Auteurs : Chieko Sakae [Japon] ; Ken Yamaguchi [Japon] ; Noriomi Matsumura [Japon] ; Hidekatsu Nakai [Japon] ; Yumiko Yoshioka [Japon] ; Eiji Kondoh [Japon] ; Junzo Hamanishi [Japon] ; Kaoru Abiko [Japon] ; Masafumi Koshiyama [Japon] ; Tsukasa Baba [Japon] ; Aki Kido [Japon] ; Masaki Mandai [Japon] ; Ikuo Konishi [Japon]

Source :

RBID : PMC:5078820

Abstract

Objective

To identify suitable diagnostic tools and evaluate the efficacy of sentinel lymph node (SLN) biopsy for inguinal lymph node metastasis in vulvar cancer.

Methods

Data from 41 patients with vulvar cancer were evaluated retrospectively, including magnetic resonance imaging (MRI) measurements, SLN biopsy status, groin lymph node metastasis, and prognosis.

Results

SLN biopsy was conducted in 12 patients who had stage I to III disease. Groin lymphadenectomy was omitted in five of the nine patients with negative SLNs. All SLN-negative patients who did not undergo groin lymphadenectomy showed no evidence of disease after treatment. On MRI, the long and short diameters of the inguinal node were significantly longer in metastasis-positive cases, compared with negative cases, in 25 patients whose nodes were evaluated pathologically (long diameter, 12.8 mm vs. 8.8 mm, p=0.025; short diameter, 9.2 mm vs. 6.7 mm, p=0.041). The threshold of >10.0 mm for the long axis gave a sensitivity, specificity, positive predictive value, and negative predictive value of 87.5%, 70.6%, 58.3%, and 92.3%, respectively, using a binary classification test. Decision tree analysis revealed a sensitivity, specificity, and accuracy of 87.5%, 70.6%, and 76.0%, respectively, with the threshold of >10.0 mm for the long axis on MRI. The criteria of >10.0 mm for the long axis on MRI predicted an advanced stage and poorer prognosis using a validation set of 15 cases (p=0.028).

Conclusion

Minimally invasive surgery after preoperative evaluation on MRI and SLN biopsy is a feasible strategy for patients with vulvar cancer.


Url:
DOI: 10.3802/jgo.2016.27.e57
PubMed: 27550403
PubMed Central: 5078820


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<name sortKey="Yoshioka, Yumiko" sort="Yoshioka, Yumiko" uniqKey="Yoshioka Y" first="Yumiko" last="Yoshioka">Yumiko Yoshioka</name>
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<name sortKey="Hamanishi, Junzo" sort="Hamanishi, Junzo" uniqKey="Hamanishi J" first="Junzo" last="Hamanishi">Junzo Hamanishi</name>
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<name sortKey="Abiko, Kaoru" sort="Abiko, Kaoru" uniqKey="Abiko K" first="Kaoru" last="Abiko">Kaoru Abiko</name>
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<name sortKey="Koshiyama, Masafumi" sort="Koshiyama, Masafumi" uniqKey="Koshiyama M" first="Masafumi" last="Koshiyama">Masafumi Koshiyama</name>
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<name sortKey="Baba, Tsukasa" sort="Baba, Tsukasa" uniqKey="Baba T" first="Tsukasa" last="Baba">Tsukasa Baba</name>
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<name sortKey="Kido, Aki" sort="Kido, Aki" uniqKey="Kido A" first="Aki" last="Kido">Aki Kido</name>
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<name sortKey="Mandai, Masaki" sort="Mandai, Masaki" uniqKey="Mandai M" first="Masaki" last="Mandai">Masaki Mandai</name>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<name sortKey="Konishi, Ikuo" sort="Konishi, Ikuo" uniqKey="Konishi I" first="Ikuo" last="Konishi">Ikuo Konishi</name>
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<title level="j">Journal of Gynecologic Oncology</title>
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<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Objective</title>
<p>To identify suitable diagnostic tools and evaluate the efficacy of sentinel lymph node (SLN) biopsy for inguinal lymph node metastasis in vulvar cancer.</p>
</sec>
<sec>
<title>Methods</title>
<p>Data from 41 patients with vulvar cancer were evaluated retrospectively, including magnetic resonance imaging (MRI) measurements, SLN biopsy status, groin lymph node metastasis, and prognosis.</p>
</sec>
<sec>
<title>Results</title>
<p>SLN biopsy was conducted in 12 patients who had stage I to III disease. Groin lymphadenectomy was omitted in five of the nine patients with negative SLNs. All SLN-negative patients who did not undergo groin lymphadenectomy showed no evidence of disease after treatment. On MRI, the long and short diameters of the inguinal node were significantly longer in metastasis-positive cases, compared with negative cases, in 25 patients whose nodes were evaluated pathologically (long diameter, 12.8 mm vs. 8.8 mm, p=0.025; short diameter, 9.2 mm vs. 6.7 mm, p=0.041). The threshold of >10.0 mm for the long axis gave a sensitivity, specificity, positive predictive value, and negative predictive value of 87.5%, 70.6%, 58.3%, and 92.3%, respectively, using a binary classification test. Decision tree analysis revealed a sensitivity, specificity, and accuracy of 87.5%, 70.6%, and 76.0%, respectively, with the threshold of >10.0 mm for the long axis on MRI. The criteria of >10.0 mm for the long axis on MRI predicted an advanced stage and poorer prognosis using a validation set of 15 cases (p=0.028).</p>
</sec>
<sec>
<title>Conclusion</title>
<p>Minimally invasive surgery after preoperative evaluation on MRI and SLN biopsy is a feasible strategy for patients with vulvar cancer.</p>
</sec>
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