Sentinel lymph node biopsy in vulvar cancer: A multicenter evaluation of procedure's feasibility for Israeli patients

Purpose: To evaluate the accuracy, safety, and outcome of sentinel lymph node biopsy (SLNB) in early-stage vulvar cancer and determine the applicability of this procedure for selected patients in Israel. Materials and Methods: Forty-five patients with T1 squamous cell carcinoma (SCC) of the vulva who underwent surgery with SLNB between 2002-2011 were included. SLN was detected using both radioactive tracer and blue dye. All resected nodes underwent pathological examination. The accuracy, recurrence rates, and complications of the procedure were analyzed. Results: There was a significant correlation between radioactive reading intensity and SLN detection in frozen section (p < 0.0003, p < 0.0001). A weaker correlation existed with use of blue dye (p = 0.04, p = 0.09). For metastatic LNs, the detection rates of both agents were similar. The false negative for metastatic SLN detection in frozen section was 12.5%, while the false positive was 2%. The rate of inguinal recurrence without local recurrence was 4.4%. For patients with unifocal vulvar disease and a negative sentinel node the seven-year survival rate was 94%. Conclusion: SLNB is an effective and safe procedure for Israeli patients with earlystage SCC of the vulva. Recurrence rates and disease-free survival are similar to the reported literature and morbidity is low compared to radical inguinal LNs resection.