Gynecol. Oncol. 2015 Sep 30
Sentinel nodes in vulvar cancer: Long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I.
ABSTRACT
OBJECTIVE
In 2008 GROINSS-V-I, the largest validation trial on the sentinel node (SN) procedure in vulvar cancer, showed that application of the SN-procedure in patients with early-stage vulvar cancer is safe. The current study aimed to evaluate long-term follow-up of these patients regarding recurrences and survival.
METHODS
From 2000 until 2006 GROINSS-V-I included 377 patients with unifocal squamous cell carcinoma of the vulva (T1, <4 cm), who underwent the SN-procedure. Only in case of SN metastases an inguinofemoral lymphadenectomy was performed. For the present study follow-up was completed until March 2015.
RESULTS
Themedian follow-up was 105 months (range 0–179). The overall local recurrence ratewas 27.2% at 5 years and 39.5% at 10 years after primary treatment, while for SN-negative patients 24.6% and 36.4%, and for SN-positive patients 33.2% and 46.4% respectively (p = 0.03). In 39/253 SN-negative patients (15.4%) an inguinofemoral lymphadenectomy was performed, because of a local recurrence. Isolated groin recurrence rate was 2.5% for SN-negative patients and 8.0% for SN-positive patients at 5 years. Disease-specific 10-year survival was 91% for SN-negative patients compared to 65% for SN-positive patients (p b .0001). For all patients, 10-year disease-specific survival decreased from 90% for patients without to 69% for patients with a local recurrence (p b .0001).
Related Questions
What if the sentinel nodes demonstrate macrometastatic disease?
New answer by at University of California, Los Angeles (June 9, 2020)
Knowing the status of the groin nodes is critical in vulva cancer, as it has important prognostic value and is considered when tailoring adjuvant therapy. Methods chosen to as...
New answer by Radiation Oncologist at Varian Medical Systems/Allegheny health network (June 13, 2022)
There is variation in practice. I tend to treat primary also along with nodal volume as long term data shows a 25- 35% risk of LR and a low 65% salvage rate. Data unknown is h...
What factors would push towards treatment? The patient had recurrence of a pT1bN0 vulvar SCC within a year of original surgery. Re-resection shows aga...
New answer by Radiation Oncologist at Vanderbilt-Ingram Cancer Center (April 4, 2023)
Most true vulvar cancer recurrences (meaning disease along the post-op cavity, not a new primary within a separate portion of the vulva), even if re-excised, will have margins...