Utility of intraoperative frozen section of the inguinofemoral sentinel lymph node in vulvar cancer: A retrospective cohort

Abstract

Objectives: To evaluate the utility of frozen section for the intraoperative assessment of sentinel lymph nodes in vulvar cancer. Methods: A total of 131 patients with vulvar cancer were treated at the University of Tennessee—West Cancer Center over a six-year period. A total of 110 were eligible for evaluation and 65 met inclusion and exclusion criteria. The clinical records were reviewed for patient demographics, disease characteristics, sentinel lymph node eligibility, surgical and pathologic variables, and follow-up status. Results: A total of 32 of the 65 eligible patients underwent sentinel lymph node detection. No significant differences in characteristics were found between the cohorts. The sentinel lymph node detection rate was 90.6% (95% CI: 75.0% - 98.0%). Sentinel lymph node was sent for frozen section in 30 patients and 5 patients were identified to have a positive SLN (16.7%). The frozen pathology results and final pathology had a 100% correspondence of both positive and negative node results. No difference in progression-free or overall survival was observed between those who underwent sentinel detection and those who did not. Download : Download high-res image (70KB) Download : Download full-size image Conclusions: Intraoperative frozen section is an appropriate means to assess node status at the time of initial surgery, decreasing the incidence of reoperation by identifying those patients who warrant immediate complete inguinal-femoral lymph node dissection.