![]() ![]() About 40% of patients treated for MCC will experience a recurrence, making it far more aggressive than most other types of skin cancer, including melanoma. can travel from the skin, through the lymphatic vessels lymphatic vessels Thin tubes that carry lymph (also called lymphatic fluid) including white blood cells through the lymphatic system to lymph nodes and eventually back into the bloodstream. Many doctors and patients are not aware of this cancer because of its recent description and relative rarity (~2,000 cases/year in the US-roughly 30 times less common than melanoma). MCC was first described in 1972 and only in the 1990s was the CK20 antibody developed to make it easily identifiable by pathologists. Merkel cell carcinoma Merkel cell carcinoma A skin cancer composed of cells that look microscopically similar to normal Merkel cells present in the skin. Purpose of a sentinel lymph node biopsy.What are the implications of these findings for clinical practice and/or further research? We describe a reproducible technique based on anatomical landmarks and an appreciation of the territorial mapping of inguinal SLN to optimise the chances of identifying the inguinal SLN in women with vulval cancer while circumventing the sequelae often attributed to this procedure. Our local figures also support the safety of this operative technique (negative nodal recurrence rate 1.7%) and compare favourably with those from the GROINSS-V study. What do the results of this study add? Our technique offers multiple advantages: our incision, albeit small, allows the operator to gain access to 96.7% of inguinal SLNs and facilitates access to both deep and superficial SLNs regardless of patients’ body mass index, minimises the need for extensive dissection and hence reduces the incidence of complications associated with overharvesting of lymph nodes such as lymphoedema or lymphocysts, particularly in obese women. A review of the literature has revealed that whilst studies have largely concentrated on the efficacy of different intraoperative detection modalities or histopathological protocols, the literature describing a standardised surgical technique remains deficient. What is already known on this subject? Inguinal sentinel lymph node (SLN) biopsy in women with vulval cancer is often construed as a challenging skill to master and the success rate of SLN detection is dependent on the experience and skill of the surgeon. Results showed that this reproducible technique allows access to 96.7% of SLNs, including both deep and superficial SLNs whilst minimising the need for extensive dissection and complications associated with overharvesting of lymph nodes.Ĭloquet Vulva cancer detection sentinel surgery. The negative nodal recurrence rate was 1.7%. The incidence of early wound cellulitis and dehiscence were 2.8% and 11.3% while lymphocysts were present in 11.3% of groins. ![]() The SLN was primarily located over Cloquet's node (85.2%). A total of 71 groins in 44 women were included. The recurrence rate at the time of the census was calculated. All women were followed up and early and late complications were recorded. The location of the SLN relative to the saphenous vein was recorded. All subjects met the GROINSS-V eligibility criteria. ![]() Data from women who underwent groin SLN biopsies for vulval cancer at a single cancer centre were prospectively collected. Our aims are (1) to describe the territorial mapping of SLNs, (2) to evaluate the associated complication rate vis-à-vis those reported in the literature, and (3) to assess its accuracy in detecting SLNs. We describe a technique based on anatomical landmarks. Inguinal lymph node involvement is the most robust predictor of mortality in vulval cancer and sentinel lymph node (SLN) biopsy is a safe diagnostic modality. ![]()
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