Cost-effectiveness of sentinel lymph node biopsy vs inguinofemoral lymphadenectomy in women with vulval cancer

A. J. Sutton*, P. Barton, S. Sundar, C. Meads, A. N. Rosenthal, P. Baldwin, K. Khan, T. E. Roberts

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background:This study examines the cost-effectiveness of sentinel lymph node biopsy, a potentially less morbid procedure, compared with inguinofemoral lymphadenectomy (IFL) among women with stage I and stage II vulval squamous cell carcinoma.Methods:A model-based economic evaluation was undertaken based on clinical evidence from a systematic review of published sources. A decision tree model was developed with the structure being informed by clinical input, taking the perspective of the health-care provider.Results:For overall survival for 2 years, IFL was found to be the most cost-effective option and dominated all other strategies, being the least costly and most effective. For morbidity-free related outcomes for 2 years, sentinel lymph node (SLN) biopsy with 99mTc and blue dye and haematoxylin & eosin (H&E) histopathology, with ultrastaging and immunohistochemistry reserved for those that test negative following H&E is likely to be the most effective approach.Conclusion:SLN biopsy using 99mTc and blue dye with ultrastaging may be considered the most cost-effective strategy based on the outcome of survival free of morbidity for 2 years. The findings here also indicate that using blue dye and H&E for the identification of the SLN and the identification of metastasis, respectively, are not sensitive enough to be used on their own. © 2013 Cancer Research UK. All rights reserved.

Original languageEnglish
Pages (from-to)2533-2547
Number of pages15
JournalBritish Journal of Cancer
Issue number10
Early online date15 Oct 2013
Publication statusPublished - 12 Nov 2013


  • sentinel lymph node
  • inguinofemoral
  • lymphadenectomy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


Dive into the research topics of 'Cost-effectiveness of sentinel lymph node biopsy vs inguinofemoral lymphadenectomy in women with vulval cancer'. Together they form a unique fingerprint.

Cite this