Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
36085090
DOI
10.1016/j.ygyno.2022.07.017
PII: S0090-8258(22)00489-9
Knihovny.cz E-resources
- Keywords
- Inguinofemoral lymphadenectomy, Lymph node metastases, Radiotherapy, Sentinel lymph node, Vulvar cancer,
- MeSH
- Sentinel Lymph Node Biopsy MeSH
- Humans MeSH
- Neoplasm Recurrence, Local pathology MeSH
- Lymph Node Excision adverse effects MeSH
- Lymphadenopathy * pathology MeSH
- Lymphatic Metastasis pathology MeSH
- Lymph Nodes pathology surgery MeSH
- Vulvar Neoplasms * pathology MeSH
- Sentinel Lymph Node * pathology surgery MeSH
- Carcinoma, Squamous Cell * pathology MeSH
- Groin MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN. METHODS: We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up. RESULTS: Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In seven patients (7/244; 2.9% [95% CI: 1.4%-5.8%]) disease was diagnosed in the contralateral groin: five had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after no further treatment. Five of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8% [95% CI: 0.1%-4.5%]) had a contralateral groin recurrence. CONCLUSION: The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases.
Amsterdam University Medical Center Amsterdam the Netherlands
Cambridge University Hospitals NHS Foundation Trust Cambridge United Kingdom
Catharina Ziekenhuis Eindhoven the Netherlands
CHUM Université de Montréal Montréal Quebec Canada
Department of Obstetrics and Gynaecology European Cancer Institute Milan Italy
Erasmus MC Cancer Institute University Medical Center Rotterdam Rotterdam the Netherlands
European Translational Oncology Prevention and Screening Institute University Innsbruck Austria
Jena University Hospital Friedrich Schiller University Jena Germany
Leeds Teaching Hospitals NHS Trust St James' University Hospital Leeds United Kingdom
Leiden University Medical Center Leiden the Netherlands
Leuven Cancer Institute Leuven Belgium
Linköping University Linköping Sweden
Maastricht University Medical Center Maastricht the Netherlands
Manchester University NHS Foundation Trust St Marys Hospital Manchester United Kingdom
Medical University Graz Graz Austria
Mount Sinai Medical Center Miami Beach FL United States of America
Nottingham University Hospitals NHS Trust Nottingham United Kingdom
Radboud University Medical Center Nijmegen the Netherlands
Sahlgrenska Academy University of Gothenburg Göteborg Sweden
St Josephs Hospital and Medical Center Phoenix AZ United States of America
Stephenson Cancer Center University of Oklahoma Oklahoma City OK United States of America
The University of Texas MD Anderson Cancer Center Houston TX United States of America
University Medical Center Groningen University of Groningen Groningen the Netherlands
University Medical Center Utrecht Utrecht the Netherlands
University of Toronto Toronto Ontario Canada
Women and Infants Hospital of Rhode Island Providence RI United States of America
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