RT Journal Article
SR Electronic
T1 2022-RA-690-ESGO Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A430
OP A430
DO 10.1136/ijgc-2022-ESGO.925
VO 32
IS Suppl 2
A1 Willemijn L van der Kolk
A1 Ate GJ van der Zee
A1 Brian Slomovitz
A1 Peter JW Baldwin
A1 Helena C van Doorn
A1 Joanne A de Hullu
A1 Jacobus van der Velden
A1 Katja N Gaarenstroom
A1 Brigitte FM Slangen
A1 Preben Kjølhede
A1 Mats Brännström
A1 Ignace Vergrote
A1 Cathrine M Holland
A1 Robert Coleman
A1 Eleonora BL van Dorst
A1 Willemien J van Driel
A1 David Nunns
A1 Martin Widschwendter
A1 David Nugent
A1 Paul A DiSilvestro
A1 Robert S Mannel
A1 Ming Y Tjiong
A1 Dorry Boll
A1 David Cibula
A1 Al Covens
A1 Diane Provencher
A1 Ingo B Runnebaum
A1 Bradley J Monk
A1 Vanna Zanagnolo
A1 Karl Tamussino
A1 Maaike HM Oonk
A1 GROINSS-V I and II participants
YR 2022
UL http://ijgc.bmj.com/content/32/Suppl_2/A430.1.abstract
AB Introduction/Background Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN.Methodology We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up.Results Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In eight patients (8/244; 3.3% [95% CI: 1.7%-6.3%]) disease was diagnosed in the contralateral groin: six had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after nu further treatment. Six of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8% [95% CI: 0.1%-4.5%]) had a contralateral groin recurrence.Conclusion The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases, particularly if the primary tumor is <30 mm.