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26.10.2015 | Gynecologic Oncology | Ausgabe 1/2016

Archives of Gynecology and Obstetrics 1/2016

The number of removed lymph nodes by inguinofemoral lymphadenectomy: impact on recurrence rates in patients with vulva carcinoma

Zeitschrift:
Archives of Gynecology and Obstetrics > Ausgabe 1/2016
Autoren:
Anja Diehl, Ruth Volland, Verena Kirn, Fabinshy Thangarajah, Christian Eichler, Thomas Einzmann, Marina Wirtz, Dominik Ratiu, Bernd Morgenstern, Claudius Fridrich, Peter Mallmann, Julian Puppe
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00404-015-3932-6) contains supplementary material, which is available to authorized users.

Abstract

Objective

Inguinal lymph node (LN) metastasis is a crucial prognostic factor in vulva carcinoma. The aim of this study was to determine the prognostic value of the number of resected LNs in patients with vulvar carcinoma on recurrence rates.

Methods

This retrospective study includes patients with vulvar squamous cell carcinoma who underwent inguinofemoral lymphadenectomy (IFL) between 1998 and 2011. Dissected groins were stratified by the number of removed lymph nodes (<6 LNs versus ≥6 LNs) or inguinal LN metastasis (pN− versus pN+) and analyzed according to groin, local and distance recurrence rates.

Results

In total 45 patients were identified and 79 groins were eligible for this analysis. 11 patients underwent ipsilateral IFL and 34 bilateral IFL. The median age was 58 years (range 31–80). The median tumor size was 2 cm (range 0.1–7.9). A median of 8 (range 0–19) LNs were resected per groin. Overall in 11 groins LN metastases were found. Groin recurrences occurred in four patients, local recurrence in six patients and distant metastasis in one patient. We did not observe any significant improvement in groin recurrence rates, local recurrence rates and distant recurrence rates if more than six LNs were removed per groin. Notably, patients with LN metastasis did not show higher recurrence rates compared to unaffected LNs.

Conclusion

In this cohort we demonstrated that resection of more than six LNs per groin does not improve the recurrence rates in patients with carcinoma of the vulva. Further prospective studies with more individuals are needed to evaluate the role of resected LNs in vulvar carcinoma.

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