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. 2024 Aug 17;10(16):e36307.
doi: 10.1016/j.heliyon.2024.e36307. eCollection 2024 Aug 30.

The clinical value of carbon nanoparticles in sentinel lymph node biopsy for early vulvar cancer

Jiahong Jiang  1   2 , Shuai Tang  1 , Yudi Li  1 , Yin Chen  2 , Xiaoxia Chen  1 , Maorui Jiang  3 , Li Deng  1 , Yanzhou Wang  1
Affiliations

The clinical value of carbon nanoparticles in sentinel lymph node biopsy for early vulvar cancer

Jiahong Jiang et al. Heliyon. .

Abstract

Objective: Carbon nanoparticle (CNP)-guided sentinel lymph node biopsy (SLNB) has been extensively adopted as a cost-effective and highly efficient method for tracing malignant tumors except for those associated with vulvar cancer. The current study aimed to validate the feasibility and efficacy of CNPs in tracking sentinel lymph nodes (SLNs) in patients with early vulvar cancer.

Methods: We retrospectively reviewed patients with vulvar cancer at our institution from January 2016 to April 2022 who were pathologically diagnosed and underwent SLNB or inguinofemoral lymphadenectomy (IFLND). CNPs were the only lymphatic tracer used in SLNB. Patient demographics, perioperative outcomes and follow-up results, including overall survival (OS) and progression-free survival (PFS), were compared between the SLNB and IFLND groups.

Results: Data from 52 patients were collected and investigated. Forty groins of 22 patients who underwent SLNB with CNP tracing were included. Black-stained SLNs were detected in 32 groins of 19 patients, and the rates of CNP detection by patient and by groin were 86.4 % and 80 %, respectively. Patients who underwent SLNB had better perioperative outcomes than those who underwent IFLND in certain aspects (groin drainage rate: 41.2 % and 80 %, respectively, p < 0.05; daily drainage volume (ml): 12.49 and 36.4, respectively, p < 0.05; and inguinal wound healing rate: 100 % and 80 %, respectively, p < 0.05). The results of survival analysis indicated similar prognoses for node-negative patients who underwent CNP-guided SLNB or IFLND.

Conclusions: Sentinel lymph node mapping with CNPs in vulvar cancer is feasible and demonstrates considerable biosecurity. With a satisfactory SLN detection rate achieved expediently, CNPs are a promising lymphatic tracer worthy of further utilization in vulvar cancer and could be an alternative option to canonical tracers.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Black-stained sentinel lymph node tracked by carbon nanoparticles (marked by the white arrow).
Fig. 2
Fig. 2
Flow chart of patients who underwent SLNB or IFLND.
Fig. 3
Fig. 3
Perioperative outcomes of SLNB and IFLND; A. Median operating time (min) of the two groups; B. Median blood loss (ml) of the two groups; C. Median hospital stay after operation (day) of the two groups; D. Median drainage time (day) of the two groups; E. Daily drainage volume (ml) of the two groups; F. Groin drainage rate (%) of the two groups; G. Inguinal recovery time (day) of the two groups; H. Inguinal wound healing rate (%) of the two groups; I. Perineal wound healing rate (%) of the two groups; J. Postoperative infection rate (%) of the two groups; K. Postoperative lymphedema rate (%) of the two groups; L. Detection rate of the metastatic LN (lymph node).
Fig. 4
Fig. 4
Follow-up of patients with negative lymph nodes in the two groups; A. Kaplan–Meier curves of the different groups in relation to OS; B. Kaplan–Meier curves of the different groups in relation to PFS.
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