Journal of Clinical Oncology, 2009 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 27, No 15S (May 20 Supplement), 2009: 5505
© 2009 American Society of Clinical Oncology

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Abstract

Sentinel node (SN) biopsy in patients with vulvar cancer: A Gynecologic Oncology Group (GOG) study

University of Texas M. D. Anderson Cancer Center, Houston, TX; GOG Statistical and Data Center, Buffalo, NY; Oklahoma University Health Science Center, Oklahoma City, OK; Columbus Cancer Council, Columbus, OH; University of Minnestoa, Minneapolis, MN

5505

Background: Vulvar cancer is a good target for SN strategy because lymphatic drainage is predictable and the morbidity of regional lymphadenectomy is significant. GOG 173 is a validation study of SN biopsy in a multi-institutional setting. Methods: Eligible patients have squamous carcinoma, nonsuspicious lymph nodes and tumor diameter between 2 cm and 6 cm. No surgeon skill verification was required. Use of radiocolloid for SN identification was an optional adjunct to blue dye until 2001 when it became mandatory. All patients underwent completion inguinal femoral lymphadenectomy. The study goal is to enroll 120 patients with nodal metastases to validate the sensitivity of SN > 88% (which would lead to a false negative predictive rate of <5% assuming the node metastases rate is 30%). Results: The study was opened in 12/1999 with 510 patients enrolled from 47 institutions (median = 5; range: 1–78 and 25^th-75^th percent: 3–14) as of 12/2008. 445 patients have data review completed. Of 403 evaluable patients, the median age was 66.9 years and 92.8% were white. 109 patients (27.1%) had lateralized lesions and unilateral groin dissections and 294 (72.9%) had midline involvement and bilateral dissections, resulting in 697 groins evaluated. SN was successfully identified in 78.8% (67/85) of patients using blue dye only and in 96.2% (306/318) using combination of radiolocalization and blue dye. For 294 patients with midline lesion treated by bilateral dissection, 159 (54.1%) had SN identified on both sides,114 (38.8%) on one side, and 21 (7.1%) not identified on either side. SN identification was successful in 373 (92.6%) patients. Nodal metastases were identified in 117 patients (31.4%). Conclusions: The combination of blue dye and radiocolloid appear superior to blue dye alone. Confirmed results for the entire cohort will be reported.

No significant financial relationships to disclose.

Abstract presentation from the 2009 ASCO Annual Meeting