Lymphadenectomy for vulvar carcinoma is characterized by many complications. Studies have demonstrated the diagnostic accuracy of sentinel lymph node biopsy (SLNB) as a valid alternative to lymphadenectomy in the early stages of vulvar squamous cell carcinoma (VSCC).Objective: To evaluate the feasibility, safety, and accuracy, as well as the oncological outcomes of SLNB following scar injection; in addition, to assess the role of a repeat sentinel node procedure in patients with local vulvar recurrence after primary treatment.Materials and Methods: A systematic computerized search of the literature was performed in the main electronic databases (MEDLINE, EMBASE, Web of Science, Pub Med, and Cochrane Library) from 2010 to August 2024. Only scientific publications in English were included. Risk of bias assessment was performed.Results: Five articles were included in the study: four retrospective and one prospective observational studies. All patients’ characteristics, including type of surgery, postoperative morbidities, adjuvant therapy, and recurrence, as well as SLN detection and oncological outcomes, have been reported. Four studies compared the scar-injection group (cases) with the tumor-injection group (controls); only one study described the SLNB after vulvar recurrence (second procedure), comparing it with SLNB during primary vulvar surgery (first procedure).Conclusions: SLNB is a feasible and safe option in patients who have had previous excision of the vulvar tumor and in patients with a recurrence of VSCC who are not able or willing to undergo lymphadenectomy. Moreover, it accurately reflects the nodal status in these patients.
外阴癌淋巴结清扫术并发症较多。研究表明，在早期外阴鳞状细胞癌（VSCC）中，前哨淋巴结活检（SLNB）作为淋巴结清扫术的有效替代方案具有较高的诊断准确性。目的：评估瘢痕注射后SLNB的可行性、安全性、准确性及肿瘤学结局；同时评估局部复发外阴癌患者初次治疗后重复前哨淋巴结活检的作用。材料与方法：在主要电子数据库（MEDLINE、EMBASE、Web of Science、PubMed和Cochrane Library）中对2010年至2024年8月的文献进行系统性计算机检索，仅纳入英文科学出版物，并进行偏倚风险评估。结果：共纳入5篇文献，包括4项回顾性研究和1项前瞻性观察研究。所有研究均报告了患者特征（包括手术类型、术后并发症、辅助治疗及复发情况）以及前哨淋巴结检出情况和肿瘤学结局。其中4项研究比较了瘢痕注射组（病例组）与肿瘤注射组（对照组）；仅1项研究描述了外阴癌复发后（二次手术）的SLNB，并将其与初次外阴手术（首次手术）中的SLNB进行比较。结论：对于既往接受过外阴肿瘤切除的患者，以及不适合或不愿接受淋巴结清扫术的VSCC复发患者，SLNB是一种可行且安全的选择，并能准确反映此类患者的淋巴结状态。
肿瘤(癌症)患者之家