Lymphoscintigraphy and sentinel lymph node biopsy in vulvar carcinoma: update from a European expert panel

Angela Collarino*, Valentina Fuoco, Giorgia Garganese, Lenka M. Pereira Arias-Bouda, Germano Perotti, Gianpiero Manca, Sergi Vidal-Sicart, Francesco Giammarile, Lioe Fee de Geus-Oei, Giovanni Scambia, Alessandro Giordano, Renato A. Valdés-Olmos, Marco Maccauro

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

31 Citations (Scopus)
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Purpose: This study aimed to update the clinical practice applications and technical procedures of sentinel lymph node (SLN) biopsy in vulvar cancer from European experts. Methods: A systematic data search using PubMed/MEDLINE database was performed up to May 29, 2019. Only original studies focused on SLN biopsy in vulvar cancer, published in the English language and with a minimum of nine patients were selected. Results: Among 280 citations, 65 studies fulfilled the inclusion criteria. On the basis of the published evidences and consensus of European experts, this study provides an updated overview on clinical applications and technical procedures of SLN biopsy in vulvar cancer. Conclusions: SLN biopsy is nowadays the standard treatment for well-selected women with clinically negative lymph nodes. Negative SLN is associated with a low groin recurrence rate and a good 5-year disease-specific survival rate. SLN biopsy is the most cost-effective approach than lymphadenectomy in early-stage vulvar cancer. However, future trials should focus on the safe extension of the indication of SLN biopsy in vulvar cancer. Although radiotracers and optical agents are widely used in the clinical routine, there is an increasing interest for hybrid tracers like indocyanine-99mTc-nanocolloid. Finally, it is essential to standardise the acquisition protocol including SPECT/CT images, and due to the low incidence of this type of malignancy to centralise this procedure in experienced centres for personalised approach.

Original languageEnglish
Pages (from-to)1261-1274
Number of pages14
JournalEuropean journal of nuclear medicine and molecular imaging
Issue number5
Publication statusPublished - 1 May 2020


  • Sentinel lymph node
  • Vulvar neoplasm
  • Lymphatic mapping
  • n/a OA procedure


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