Rationale: Radical excision of the vulvar tumor together with inguinofemural lymphadenectomy (IFL) represents the goal of surgery in early stage squamous vulvar cancer (VC). However, in spite of the satisfactory overall survival rates, the postoperative morbidity rate (e.g infection, wound seromas, lymphatic secretion) is relative high which has resulted in the need of detection of a less invasive method that can identify with a high accuracy the presence of metastases in the inguinofemural lymph nodes (LNs).
The detection of the sentinel lymph node(s) (SLNs) in early-stage VC is feasible and is associated with a lower recurrence rate, a higher overall survival rate as well as a lower short-and long-term morbidity rate.
Aim: To examine the body literature regarding the feasibility, oncological safety and clinical utilityof the SLN biopsy in early-stage VC.
Method: A systematic literature review was performed by searching for English articles in PubMed and Mediline databases with no date limitations using the following key words: “vulvar cancer”, “sentinel lymph node”, “dissection”.
Conclusion: Performing the SLN biopsy is provides important staging information and has a positive impact on the quality of life of these patients. However,owing to the reported relative high false-negative rates the SLN dissection procedure without complete IFL has still not have been introduced in the routine management of early-stage vulvar cancer.
Abbreviations: IFL = inguinofemural lypmhadenetomy; VC = vulvar cancer; LN = lymph node; SLN = sentinel lymph node; GOG = gynecologic Oncologic Group
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