Sentinel Lymph Node Biopsy for Early Stage Vulvar Squamous Cell Carcinoma

Abstract

Abstract Background and Objectives: Patients with regional lymph node (LN) involvement from squamous cell carcinoma (SCC) of the vulva have a 48% 5-year relative survival. Recently, sentinel LN (SLN) biopsy has become a viable alternative to inguinofemoral lymphadenectomy. We sought to identify risk factors for predicting a positive SLN in patients with vulvar SCC. Methods: A retrospective review of 29 patients with vulvar SCC was performed from 2016-2021 at a tertiary care center. Clinicopathologic data was collected in addition to SLN status including number of LN removed. Results: The average depth of invasion was 7.9 mm, average tumor size was 1.8 cm, 3/23 patients had PNI, and 4/23 patients had LVI. One patient who did not map on lymphoscintigraphy and 5 patients with recurrent vulvar SCC were excluded from final analysis. The average number of SLNs removed was 2. One patient had a positive SLN: the depth of invasion was 17 mm, tumor size was 5.1 cm, and LVI was present. Conclusions: The majority of patients with early stage vulvar SCC had a negative SLN biopsy. Further study is needed to determine the patient subset that could avoid SLN biopsy altogether.