van der Kolk, Willemijn (2022) Omitting contralateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe. thesis, Medicine.
Full text available on request.Abstract
Background – Treatment of patients with early-stage vulvar squamous cell carcinoma (VSCC) consists of a wide local excision and groin treatment, i.e., sentinel lymph node (SN) biopsy and if indicated, unilateral or bilateral inguinofemoral lymphadenectomy (IFL). In practice bilateral IFL is still widely performed, although it is associated with higher treatment-related morbidity. The aim of the study was to investigate if contralateral IFL can be safely omitted in patients with a unilateral metastatic SN. Methods – We determined the incidence of contralateral additional non-SN metastases at bilateral IFL and contralateral groin recurrences during follow-up in patients who participated in GROINSS-V I or II with a unilateral metastatic SN. We also investigated tumor location as a prognostic factor for the development of contralateral groin non-SN metastases and contralateral groin recurrences, and for survival. Results – We analyzed 1917 patients with early-stage VSCC. In total, 366 patients had a unilateral metastatic SN. In eight patients (8/255; 3.1% [95% CI: 1.6%-6.1%]) treated with uni- or bilateral IFL or unilateral radiotherapy, a contralateral non-SN metastasis or contralateral groin recurrence was found. Six of these patients had a tumor ≥ 30mm. No significant difference between different tumor locations was found for survival and occurrence of contralateral non-SN metastases or contralateral groin recurrences. Conclusion – It is safe to omit contralateral IFL in patients with early-stage VSCC with a unilateral metastatic SN who underwent a successful SN biopsy. Caution should be taken in patients with larger tumors. Tumor location has no influence on occurrence of contralateral additional non-SN metastases and contralateral groin recurrences, or on survival.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Oonk, dr. Maaike and van der Zee, prof. dr. Ate |
| Faculty: | Medical Sciences |
| Date Deposited: | 12 Jun 2023 12:59 |
| Last Modified: | 12 Jun 2023 12:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3552 |
Actions (login required)
 |
View Item |