Introduction/Background Local recurrences of vulvar squamous cell carcinoma (VSCC) are reported in up to 40% of patients. Knowledge of the risk of inguinofemoral lymph node metastases in local recurrences is necessary to optimally counsel patients with respect to treatment of the groins, and to explore alternative treatment regimens. The aim of our study is to determine the incidence and prognostic factors of lymph node metastases in women with a first local recurrence of VSCC.
Methodology A nation-wide multicenter retrospective study was performed, including all patients with a first local recurrence of VSCC after primary surgical treatment with curative intent between 2000–2015. Interim analysis was conducted on the results of four out of eight participating gynecologic oncology centers (Academic Medical Center, Amsterdam; Erasmus Medical Center, Rotterdam; University Medical Center Groningen, Groningen and Radboud University Medical Center, Nijmegen).
Results We retrieved 292 patients with a macro-invasive local recurrence of VSCC. The median follow-up after local recurrence was 61 months (range 2–208). The median interval time between the primary VSCC and the first local recurrence was 27 months (range 1–201) with a median age of 74 years (range 28–99). Positive inguinofemoral lymph nodes were present in 15.8% of the patients with a local recurrent VSCC. Significant differences for tumor size (median 25 mm vs 14 mm, p<0.01) and depth of invasion (4.8 mm vs 3.1 mm, p=0.01) were found in relation to the lymph node status.
Conclusion Our study demonstrates an incidence rate of 15.8% of inguinofemoral lymph node metastases in women with a first local recurrence of VSCC. A larger tumor size and depth of invasion were significant prognostic factors for the presence of positive lymph nodes at the time of recurrent disease. More research is needed to accurately identify patients at high risk for lymph node metastases, in order to individualize treatment and follow-up.
Disclosure Nothing to disclose
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