TY - JOUR T1 - Trans-inguinal pelvic lymphadenectomy in vulvar cancer patients: TRIPLE pilot study JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 846 LP - 852 DO - 10.1136/ijgc-2022-003347 VL - 32 IS - 7 AU - Giorgia Garganese AU - Simona Maria Fragomeni AU - Luigi Della Corte AU - Carmine Conte AU - Benito Marinucci AU - Luca Tagliaferri AU - Stefano Gentileschi AU - Giacomo Corrado AU - Giuseppe Vizzielli AU - Giovanni Scambia Y1 - 2022/07/01 UR - http://ijgc.bmj.com/content/32/7/846.abstract N2 - Objective The goal of this study was to assess the feasibility and safety of a retrograde extraperitoneal trans-inguinal novel approach to pelvic lymphadenectomy in vulvar cancer patients. The secondary objectives were to assess complications (early and late) and oncological outcomes.Methods In this pilot study, all patients referred to our institution from November 2019 to May 2021 were evaluated. The inclusion criteria were patients diagnosed with primary/recurrent vulvar cancer and who were candidates for concomitant groin and pelvic lymph node dissection. A consecutive sampling was planned during the study period. After conventional inguino-femoral lymph nodal dissection, ipsilateral extraperitoneal trans-inguinal pelvic lymphadenectomy (TRIPLE) was performed through a groin incision. Clinical data, type of treatment, perioperative complications, and follow-up were evaluated.Results 13 patients (8 primary, 5 recurrent vulvar cancer) underwent 16 TRIPLE procedures (10 unilateral, 3 bilateral). The median age was 69 years (range 58–93 years); 8 patients had comorbidities (61.5%). Up front locoregional radiotherapy was previously performed in two cases (15.4%). The pathology report showed metastatic lymph nodes in 20 (87%) groins and 11 (68.8%) pelvic sites; the mean number of removed and metastatic pelvic lymph nodes was 12.1 (range 5–33) and 2.9 (range 0–18), respectively. No intra-operative site-specific complications occurred. One (5.9%) post-operative site-specific complication was reported (pelvic abscess, grade 2), which was treated with antibiotics. One patient died due to concomitant pneumonia. No unilateral pelvic lymph node recurrence occurred during follow-up (median 13 months, range 2–43 months); 3 patients (23.1%) had distant site recurrence (median disease-free survival 9 months).Conclusions TRIPLE seems to be a feasible and safe technique, providing adequate lymph node dissection. Despite being a high-risk and fragile population, morbidity was similar to previously reported data for conventional mini-invasive approaches. Prospective larger comparative series are necessary.Data are available upon reasonable request. The data presented in this study are available on reasonable request, from the corresponding author. The data are not publicly available due to privacy restriction. ER -