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Number of Nodes Removed With Inguinofemoral Lymphadenectomy and Risk of Isolated Groin Recurrence in Women With FIGO Stage IB–II Squamous Cell Vulvar Cancer
  1. Francesco Sopracordevole, MD*,
  2. Nicolò Clemente, MD*,
  3. Giorgio Giorda, MD*,
  4. Vincenzo Canzonieri, MD,
  5. Lara Alessandrini, MD,
  6. Anna del Fabro, MD*,
  7. Matteo Serri, MD and
  8. Andrea Ciavattini, MD
  1. *Gynecological Oncology Unit, and
  2. Pathology Unit, IRCCS CRO Centro di Riferimento Oncologico–National Cancer Institute, Aviano; and
  3. Woman's Health Sciences Department, Gynecologic Section, Università Politecnica delle Marche, Ancona, Italy.
  1. Address correspondence and reprint requests to Nicolò Clemente, MD, Gynecological Oncology Unit, Centro di Riferimento Oncologico–National Cancer Institute, Via F. Gallini 2, 33081 Aviano, Italy. E-mail: nicoclemente{at}


Aim The aim of this study was to evaluate if the lymph node count from inguinofemoral lymphadenectomy impacted the risk of isolated groin recurrence in patients with node-negative squamous cell vulvar cancer.

Materials and Methods This is a retrospective cohort study of women with squamous cell vulvar cancer (stage IB–II according to the 2009 Revised International Federation of Gynecology and Obstetrics staging system) who underwent primary radical vulvar surgery and groin lymphadenectomy between January 2005 and December 2014. Patients' sociodemographic characteristics, the disease characteristics, the number of nodes removed from each groin, and the oncologic outcome were evaluated. A cutoff value of at least 6 nodes removed from each groin was used to define the adequacy of inguinofemoral dissection.

Results Seventy-six patients, fulfilling the study inclusion criteria, were considered. The mean number of nodes removed (bilaterally) was 14.5 (±5.3, SD), with a range of 2 to 29 nodes. Thirty-three women (43.4%) had less than 6 nodes removed from each groin. In the whole study cohort, 4 cases of isolated groin recurrence (5.3%) were detected, and all these recurrences developed in patients with less than 6 nodes removed. Considering the demographic, clinical, and histopathological characteristics potentially related to the risk of groin recurrence, only the number of nodes removed showed a significant correlation.

Conclusions Women treated for vulvar cancer in which less than 6 nodes are removed from each groin are at higher risk of groin recurrence.

  • Vulvar cancer
  • Inguinofemoral node dissection
  • Groin dissection
  • Lymphadenectomy
  • Groin recurrence
  • Inguinofemoral recurrence

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  • Francesco Sopracordevole and Nicolò Clemente contributed equally to this work.

  • The authors declare no conflicts of interest.