Introduction/Background Lymph node involvement is the most important prognostic factor for recurrence and survival in vulvar cancer. Therefore, systematic inguinofemoral lymphadenectomy (IL) is a standard procedure in patients with metastatic disease in one or more inguinal lymph nodes.
Methodology To assess the current management of diagnostic and surgical procedures concerning IL in patients with vulvar cancer, a web-based survey was e-mailed to 612 gynecological departments. Data were presented as frequencies of selected items. Logistic regression analysis was used to assess differences in IL procedures concerning demographic variables of the respective departments.
Results A total of 191 hospitals (31.21%) answered the questionnaire concerning the management of IL. 94.1% of hospitals performed the IL by open surgery. Only 78.2% of hospitals dissected the fascia cribrosa to remove the deep inguinal lymph nodes. Being a certified gyneco-oncological center significantly increased the odds for complete IL (OR 2.803; 95% CI 1.317–5.964; p=0.007). Having two or more specialized gyneco-oncologists in the department significantly increased the odds of performing total IL (two specialized gyneco-oncologists OR 3.341; 95% CI 1.237–9.026; p=0.017, and more than two specialized gyneco-oncologists OR 3.964; 95% CI 1.318–11.925; p=0.014), and reporting a surgical experience of more than ten years significantly decreased the odds (OR 0.212; 95% CI 0.048–0.928; p=0.040), respectively.
Conclusion Being a specialized gyneco-oncological center and having two or more gyneco-oncological specialists significantly increased the odds of performing a complete inguinal lymphadenectomy in women with vulvar cancer. This procedure is crucial, as the recurrence rate was higher in women who did not receive total inguinal lymphadenectomy (7.3% vs. 0%, respectively) (Stehman et al., 1992). Thus, centralization of treatment of women with vulvar cancer may lower the groin recurrence rate and may increase survival.
Disclosures See attached files (COIs).
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