Radical vulvectomy and bilateral inguinal lymphadenectomy through separate groin incisions

Hacker, N F; Leuchter, Ronald S.; Berek, J. S.; Castaldo, Thomas W.; Lagasse, Leo D.

doi:10.1016/0090-8258(80)90119-5

Cited by 86 publications

(131 citation statements)

References 0 publications

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…Although skin bridge recurrences mostly develop in patients with positive lymph nodes [16], other studies reported patients with negative nodes who developed a recurrent tumor in the skin bridge as well [8,[10][11][12]17]. Our data are in accordance with others who also did not find any skin bridge recurrence after modifications in the treatment of patients with vulvar cancer [18][19][20].…”

Section: Discussionsupporting

confidence: 90%

“…In patients without a groin recurrence, the mean number of removed lymph nodes was 16 (range 3-35). In patients who developed a groin recurrence after negative lymph nodes, the mean number of removed lymph nodes was 13 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. This difference is not significant (t = 1,74: df = 90: P = 0.09).…”

Section: Recurrencesmentioning

confidence: 99%

See 1 more Smart Citation

Patterns and frequency of recurrences of squamous cell carcinoma of the vulva

Woolderink

Bock

Hullu

et al. 2006

Gynecologic Oncology

View full text Add to dashboard Cite

Objective. To analyze patterns and frequency of recurrences of squamous cell carcinoma (SCC) of the vulva after wide local excision (WLE) and superficial inguinal lymphadenectomy with separate incisions and to identify prognostic factors for the development of recurrences.Methods. Between January 1985 and December 1999, all 125 consecutive patients with primary SCC of the vulva, treated with WLE and superficial inguinal lymphadenectomy, were retrospectively analyzed. Recurrences were registered by localization as: local, skin bridge, groin or distant.Results. A local recurrence was diagnosed in 29 (23%) patients, 11 (9%) developed a groin and 4 (3%) a distant recurrence. No skin bridge recurrences were identified. The 5 years local relapse-free survival was 70%. After a first local recurrence, 72% of these patients developed a second local recurrence. Adjusted for other predictors, older age (>74 years) is an independent risk factor for local recurrences (HR: 2.38; 95%-C. I.: 1.08-5.23) and stage III/IV cancer for developing groin/distant recurrences (HR: 3.03; 95%-C.I.: 1.0-9.18).Conclusion. WLE and superficial inguinal lymphadenectomy with separate incisions result in a high groin recurrence rate in this study; superficial lymphadenectomy should be replaced by deep inguinofemoral lymphadenectomy. After a local recurrence, 72% of the patients developed a second local recurrence. These patients are at high risk and need a close follow-up.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Recurrencesmentioning

confidence: 99%

Patterns and frequency of recurrences of squamous cell carcinoma of the vulva

Woolderink

Bock

Hullu

et al. 2006

Gynecologic Oncology

View full text Add to dashboard Cite

show abstract

“…In 1981, Hacker et al published results from 100 patients after separate incisions and observed no groin recurrences and 2 skin bridge recurrences, both in patients with lymph node metastases. 11 In addition, in patients without lymph node metastases, incidental skin bridge recurrences have been reported, whereas groin recurrences are very rare. 3,[12][13][14][15][16] Despite salvage therapy, all seven patients with skin bridge and groin recurrences in our study died of disease.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, seroma and lymphedema of the legs still were observed frequently, whereas only occasional tumor recurrences in the skin bridge have been reported. [11][12][13][14][15][16] The Cochrane Collaboration proposed five levels of evidence (Levels 1-5) for ranking the validity of different types of studies. 17 No prospective, randomized studies (Level 1) have ever been performed that compared radical surgery with modified radical surgery for patients with vulvar carcinoma.…”

mentioning

confidence: 99%

Vulvar carcinoma

Hullu

Hollema²,

Lolkema³

et al. 2002

Cancer

249

View full text Add to dashboard Cite

BACKGROUNDThe objective of this study was to determine whether modifications in the treatment of patients with vulvar carcinoma influence the rates of recurrence and survival.METHODSBetween 1982 and 1997, 253 patients with T1 and T2 invasive squamous cell carcinoma of the vulva were treated by essentially the same team of gynecologic oncologists, and 168 patients (Group I) underwent radical vulvectomy with en bloc inguinofemoral lymphadenectomy. Standard therapy was changed in 1993, and 85 patients (Group II) underwent wide local excision with inguinofemoral lymphadenectomy through separate incisions. The rates of recurrence and survival were compared between both groups.RESULTSIn Group II, the overall recurrence rate (33.3%) within 4 years was increased compared with Group I (19.9%; P = 0.03). In Group II, 5 of 79 patients (6.3%) developed fatal groin or skin bridge recurrences compared with 2 of 159 patients (1.3%) in Group I (P = 0.029); this did not result in a difference in overall survival. In Group II, 40 of 79 patients had tumor free margins measuring ≤ 8 mm, resulting in 9 local recurrences; whereas 39 of 79 patients had tumor free margins measuring > 8 mm, resulting in no local recurrences (P = 0.002).CONCLUSIONSThe current study showed that fatal recurrences in either the groin or the skin bridge were more frequent after wide local excision and inguinofemoral lymphadenectomy through separate incisions; however, probably due to lack of power, this did not result in shorter survival. In 40 of 79 patients, the histologic margins measured ≤ 8 mm, resulting in a high risk of local recurrences. Therefore, the authors recommend obtaining surgical margins of 2 cm for the local treatment of patients with vulvar carcinoma. Cancer 2002;95:2331–8. © 2002 American Cancer Society.DOI 10.1002/cncr.10969

show abstract

“…Until recently inguinofemoral lymphadenectomy was the only possibility to be adequately informed on the lymph node status. However, the morbidity of this procedure is high, while only 25-35% of early stage vulvar cancer patients will have lymph node metastases and thereby benefit from this surgery [1,2]. In the other 65-75% this intervention will (in retrospect) probably be only diagnostic.…”

Section: Introductionmentioning

confidence: 99%

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Oonk

Bock

et al. 2009

Gynecologic Oncology

View full text Add to dashboard Cite

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy Oonk, M. H. M.; van Os, M. A.; de Bock, G. H.; de Hullu, J. A.; Ansink, A. C.; van der Zee, A. G. J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Objectives. The SLN-procedure has been introduced in vulvar cancer treatment to reduce morbidity and thereby improve quality of life. Aim of this study was to compare quality of life in vulvar cancer patients who were treated with a SLN-procedure only to those who underwent inguinofemoral lymphadenectomy. Moreover, it was evaluated what patients would advise relatives on the application of the SLN-procedure in light of possible false negative results.Methods. Patients who participated in the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) were invited to fill out three questionnaires: the EORTC QLQ-C30, a vulvar specific questionnaire and a questionnaire about the opinion of patients on new treatment options. Patients who only underwent SLN-procedure were compared to those who subsequently underwent inguinofemoral lymphadenectomy because of a positive SLN.Results. With a response rate of 85%, 35 patients after the SLN-procedure and 27 patients after inguinofemoral lymphadenectomy filled out the questionnaires. No difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of lymphedema of the legs after inguinofemoral lymphadenectomy. The majority of patients would advise the SLN-procedure to relatives. Patients after inguinofemoral lymphadenectomy were more reserved concerning the acceptable false negative rate of a new diagnostic procedure.Conclusions. Patients who underwent the SLN-procedure report less treatment related morbidity compared to those who underwent inguinofemoral lymphadenectomy. However, this did not influence overall quality of life. Furthermore, patients who underwent inguinofemoral lymphadenectomy are more reserved in advising the SLN-procedure to relatives.

show abstract

Radical vulvectomy and bilateral inguinal lymphadenectomy through separate groin incisions

Cited by 86 publications

References 0 publications

Patterns and frequency of recurrences of squamous cell carcinoma of the vulva

Patterns and frequency of recurrences of squamous cell carcinoma of the vulva

Vulvar carcinoma

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Contact Info

Product

Resources

About