Gynaecological oncology: sentinel node biopsy in vulval cancer: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: sentinel node biopsy in vulval cancer

Sample item

A woman has a unifocal 2 cm squamous carcinoma of the vulva with clinically normal groins. What is the advantage of sentinel node biopsy over full inguinofemoral lymphadenectomy?

AIt removes the need to excise the primary tumourBHigher survival even if nodes are involvedCBetter detection of pelvic nodal diseaseDFewer wound complications and less leg lymphoedema

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Fewer wound complications and less leg lymphoedema

Full groin dissection causes frequent wound breakdown and chronic leg lymphoedema. In a small unifocal tumour with clinically negative groins, a negative sentinel node allows groin dissection to be omitted with much lower morbidity.

Option by option

A. It removes the need to excise the primary tumour
The primary tumour still needs wide local excision.
B. Higher survival even if nodes are involved
It is chosen for lower morbidity and not for a survival advantage.
C. Better detection of pelvic nodal disease
It samples groin nodes and does not evaluate pelvic nodes.
D. Fewer wound complications and less leg lymphoedema (correct)
Correct. Sparing negative groins avoids the morbidity of full dissection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Fewer wound complications and less leg lymphoedema. Full groin dissection causes frequent wound breakdown and chronic leg lymphoedema.

Why is "It removes the need to excise the primary tumour" not the answer?

The primary tumour still needs wide local excision.

Why is "Higher survival even if nodes are involved" not the answer?

It is chosen for lower morbidity and not for a survival advantage.

Why is "Better detection of pelvic nodal disease" not the answer?

It samples groin nodes and does not evaluate pelvic nodes.

What concept does this question test?

It tests Gynaecological oncology: sentinel node biopsy in vulval cancer in OBG. In a small unifocal tumour with clinically negative groins, a negative sentinel node allows groin dissection to be omitted with much lower morbidity.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: sentinel node biopsy in vulval cancer?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.