Identification of Inguinal Lymph Node Metastases from Vulval Carcinoma by Magnetic Resonance Imaging: an Initial Report
2003; Elsevier BV; Volume: 58; Issue: 5 Linguagem: Inglês
10.1016/s0009-9260(03)00087-4
ISSN1365-229X
AutoresDesmond P.J. Barton, J. H. Shepherd, E. Moskovic, S.A. Sohaib,
Tópico(s)Endometrial and Cervical Cancer Treatments
ResumoWe read with interest the recent paper by Hawnaur et al. [ 1 Hawnaur J.M. Reynolds K. Wilson G. Hillier V. Kitchener H.C. Identification of inguinal lymph node metastases from vulval carcinoma by magnetic resonance imaging: an initial report. Clin Radiol. 2002; 57: 995-1000 Abstract Full Text PDF PubMed Scopus (46) Google Scholar ]. As is well known, groin surgery in vulval cancer, which is associated with considerable morbidity, is performed to diagnose metastatic disease and for therapeutic goals. It is difficult, however, to argue that this surgery has substantial therapeutic benefit for patients with early-stage vulval cancer (T1 or T2), not least because about 80% of these patients do not have metastatic disease. Furthermore, recent radiological studies in vulval cancer suggest that it may be possible to diagnose lymph node status without recourse to a formal lymphadenectomy. Hawnaur et al. describe the findings from a small preliminary study and suggest that groin magnetic resonance imaging (MRI) may have a role in detecting metastatic disease. Four of their 10 patients had locally advanced disease (i.e. T3 cancers), whereas arguably avoidance of groin node surgery will be of greater relevance in patients with T1 and T2 cancers. The authors also report that they were able to anatomically match or map the resected groin nodes with the MRI findings—which we would argue is fraught with difficulty. We reported, in a retrospective study on the use of MRI in 22 patients with vulval cancer, a sensitivity and specificity for detection of groin node metastasis of 40–50% and 97–100% (the variation was related to whether the nodes assessed were superficial or deep) [ 2 Sohaib S.A.A. Richards P.S. Ind T. et al. MR imaging of carcinoma of the vulva. AJR Am J Roentgenol. 2002; 178: 373-377 Crossref PubMed Scopus (82) Google Scholar ].
Referência(s)