Pitfalls in the sentinel lymph node procedure in vulvar cancer

Objectives. There is an increasing interest among gynecologic oncologists to implement the sentinel lymph node (SLN) procedure in vulvar cancer patients in clinical practice. However, the safety of this promising method of staging still has to be proven in a randomized trial.Materials and methods. Two vulvar cancer patients are reported to illustrate pitfalls in the sentinel lymph node procedure.Results. The phenomena of bypassing the sentinel lymph node and confusion about the number of removed sentinel lymph nodes are presented and discussed.Conclusion. Gynecological oncologists who perform the sentinel lymph node procedure in vulvar cancer patients should perform this technique by following a strict protocol and within the protection of a clinical trial. (C) 2004 Elsevier Inc. All rights reserved.