A PILOT-STUDY UTILIZING INTRAOPERATIVE LYMPHOSCINTIGRAPHY FOR IDENTIFICATION OF THE SENTINEL LYMPH-NODES IN VULVAR CANCER

Objective. To identify sentinel lymph nodes using intraoperative lymph oscintigraphy. Methods. Technetium-99-labded sulfur colloid was inject ed at the site of primary vulvar carcinoma, An intraoperative gamma co unter was used to identify one or more sentinel lymph nodes. Results. Ten patients underwent bilateral inguinal and femoral lymphadenectomy. The clinical stages are as follows: T1 in 6, T2 in 2, and T3 in 2. A total of four groins (3 patients) were positive for metastases. In one patient only the sentinel node was positive for disease, In a second patient, two unilateral nodes were positive for disease and both were identified with the gamma counter as sentinel nodes, In the third pati ent, a single sentinel node was positive for malignancy in each groin, Multiple nonsentinel lymph nodes were positive in each groin in this patient. In no case was the sentinel node negative when other nonsenti nel nodes were positive. Conclusion. Intraoperative lymphoscintigraphy quantitatively identifies one or more sentinel lymph nodes, Since sen tinel lymph nodes can be localized transcutaneously, this technique ma y be useful for selective lymphadenectomy. Larger patient accrual is n ecessary to verify this technique. (C) 1997 Academic Press.