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EP1169 Laparoscopic pelvic lymphadenectomy in vulva cancer vs postoperative radiation in pelvic area
  1. EG Klonos1,
  2. MZ Muallem1,
  3. J Muallem1,
  4. I Hatoum1,
  5. AZ Tolkos2 and
  6. J Sehouli1
  1. 1Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Clinic, Berlin, Germany
  2. 2Aristotle University of Thessaloniki, Thessaloniki, Greece

Abstract

Introduction/Background Vulval Cancer constitutes worldwide 5.1% of all gynaecologic malignancies.The treatment is mainly based on the surgical approach. Recently, due to the modern surgical treatment, pelvic lymphadenectomy is crucial in the treatment of vulva cancer. Reviewing the literature about this topic the patients are divided into two subgroups: 1) those receiving post-operative radiotherapy in the inguinal and pelvic area 2)and in those with the pelvic lymphadenectomy after having undergone radical vulvectomy and inguinal lymphadenectomy without any postoperative radiotherapy of inguinal area although the positive groin nodes.The results showed a superiority of radiotherapy compared to surgical treatment.

Methodology From January 2015 to December 2017, after vulvectomy pelvic lymph nodes were removed in seven patients, five of whom were laparoscopic performed and in two with laparotomy. Four patients were stage T1b,two T2p and one patient T1a. The age of the patients ranges from 44 to 81 with an average age of 63.3. All operations were performed at the Charite Campus Wirchow Berlin in Gynecology Oncology Department by the same surgeon.The including crtiteria for undergoing pelvic lymphadenectomy were : i) ≥ 2 positive inguinal Lymphnodes, ii)1 inguinal Lympnode with size ≥ 10 mm or iii)1 Lymphnode with extracapsular spread.

Results In our study we present a number of patients,who were radical vulvectomy as well as inguinal and pelvic lymphadenectomy operated. In the case of positive inguinal and negative pelvic lymphnodes, postoperative radiation was limited locally only in the inguinal area and not in the pelvic, since only pelvic lymphnodes excision was sufficient and the patients showed an excellent follow-up.

Conclusion Laparoscopic Lymphadenectomy seems to be a safe method to avoid postoperative radiation in the pelvic area regarding the excellent follow up. But due the low number of the patients, it is necessary to be more researched to find out the proper treatment in vulva cancer.

Disclosure Nothing to disclose

https://doi.org/10.1136/ijgc-2019-ESGO.1210

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