Size of sentinel-node metastasis and chances of non-sentinel-node involvement and survival in early stage vulvar cancer: results from GROINSS-V, a multicentre observational study

Oonk, Maaike H. M.; Hemel, Bettien M. van; Hollema, Harry; Hullu, Joanne A. de; Ansink, Anca C.; Vergote, Ignace; Verheijen, René H.M.; Maggioni, Angelo; Gaarenstroom, Katja N.; Baldwin, Peter; Dorst, Eleonora B van; Velden, J. van der; Hermans, R; Putten, Hans W van der; Drouin, P; Runnebaum, Ingo B.; Sluiter, Wim J.; Zee, Ate Gj van der

doi:10.1016/s1470-2045(10)70104-2

Cited by 233 publications

(175 citation statements)

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“…Those patients with submicrometastases ( ≤0.2 mm) are classified as N0 and patients are treated as lymph node negative 39 [ ] . In vulvar cancer, Oonk, et al assessed the association between the size of sentinel node metastasis and the risk of metastasis in non-sentinel nodes, and risk of disease-specific survival 40 [ ] . They found the risk of additional non-sentinel-node metastases increased with the size of the sentinel-node metastasis.…”

Section: Ratio Of Positive Lymph Nodesmentioning

confidence: 99%

Lymph node metastases and prognosis in penile cancer

Zhu

2012

Chin. J. Cancer Res.

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Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables, such as the number of metastatic lymph nodes, bilateral lymph node metastases, the ratio of positive lymph nodes, extracapsular extension of metastatic lymph nodes, pelvic lymph node metastases, metastatic deposit in sentinel lymph nodes and N stage in TNM classification. Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed.

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Section: Ratio Of Positive Lymph Nodesmentioning

confidence: 99%

Lymph node metastases and prognosis in penile cancer

Zhu

2012

Chin. J. Cancer Res.

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“…Therefore, additional treatment was recommended to all SLN positive patients, but it always increases side effects and lowers quality of life [23]. Our study suggests that a negative VEGF-C expression in SLN metastases could act as an indicator of cancer-free non-SLNs.…”

Section: Discussionmentioning

confidence: 76%

Can vascular endothelial growth factor C expression be of use in predicting surgical stage or prognosis in vulvar cancer ?

Nyberg¹,

Laurila²,

Staff³

et al. 2017

J Cancer Res Ther.

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Introduction: Nodal metastasis is a main prognostic factor in vulvar cancer. Increased vascular endothelial growth factor C (VEGF-C) expression has been associated with lymph node metastasis and poor prognosis in many cancers. The aim of this retrospective study was to investigate VEGF-C expression pattern in the invasive edge of vulvar cancer and in sentinel lymph node metastasis, and its association with the stage and prognosis. Methods: Tumor and sentinel lymph node samples from 44 patients were evaluated with immunohistochemistry, and the results were linked with the clinicopathological data. Results: Sixty-seven percent of primary tumors and 76% of sentinel lymph node metastases expressed VEFG-C. Positive VEGF-C expression of the primary tumor did not predict surgical Stage or sentinel lymph node involvement. The risk of relapse was not significantly higher with VEGF-C expressing tumors than with VEGF-C negative tumors (RR 2.55, 95% CI 0.66-9.90, p = 0.18). The risk of groin recurrence was significantly lower with VEGF-C positive than negative tumors (RR 0.36, 95% CI 0.16-0.79, p = 0.01). Survival was similar in both groups. No non-sentinel lymph node metastases were found in case of negative VEGF-C expression in the sentinel lymph node metastasis, whereas with positive VEGF-C expression they were found in 5/13 (38%) of cases. Conclusions: Tumoral VEGF-C expression was not associated with higher surgical Stage or poorer prognosis in vulvar cancer. However, absence of its expression in sentinel lymph node metastasis might indicate a low risk for non-sentinel lymph node metastases.

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“…A total number of 163 positive nodes were detected, of which 95 (58%) were detected by routine pathological examination and 68 (42%) by ultrastaging. Oonk et al 22 showed that the risk of nonsentinel node metastases increases with the size of the sentinel lymph node metastases; one of 24 patients (4%) with isolated tumor cells had non-sentinel lymph node metastases. Furthermore, they showed that the prognosis of patients with a positive sentinel lymph node based on isolated tumor cells is similar to patients with a negative sentinel lymph node.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, they showed that the prognosis of patients with a positive sentinel lymph node based on isolated tumor cells is similar to patients with a negative sentinel lymph node. 5,22 However, firm conclusions are difficult to draw because of the lack of power, and therefore Oonk et al 22 recommend additional groin treatment for all patients with vulvar SCC with sentinel lymph node metastases, regardless of the size of the lymph node metastases. Besides, the therapeutic effect of this procedure, which was part of the routine treatment, is undefined.…”

Section: Discussionmentioning

confidence: 99%

An alternative way to measure the depth of invasion of vulvar squamous cell carcinoma in relation to prognosis

et al. 2015

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Depth of invasion is an important prognostic factor for patients with vulvar squamous cell carcinoma. The aim of this study was to identify the most optimal method of measuring the depth of invasion in relation to the individual outcome in patients with vulvar squamous cell carcinoma. Data of 175 consecutive patients with a primary vulvar squamous cell carcinoma with known lymph node status, treated in the Radboud University Medical Center, the Netherlands (2000Netherlands ( -2010, were stored in a database. At pathology review of 148 (85%) cases, depth of invasion was measured using the conventional and alternative methods. Clinical and pathological characteristics of patients with a change in FIGO stage were compared with those without a change in stage. In 148 vulvar squamous cell carcinoma patients, the median depth of invasion was shown to be decreased from 5.5 mm (range 1.1-20) using the conventional method to 3.6 mm (range 0.2-20) using the alternative method (Po0.05). This led to a change in the FIGO stage in 13 of the 148 (9%) patients and a change in depth of invasion from 3.5 to 0.2 mm in one patient (1%) with FIGO stage IIIA. Of all 69 stage 1B patients, 13 (19%) were downstaged to stage IA. The downstaged patients developed less recurrences (15% vs 39%) and had a higher disease-specific survival (100% vs 84%) compared with the patients who remained FIGO stage IB. Using the alternative method for measuring the depth of invasion in tumors of vulvar squamous cell carcinoma patients, 19% of the patients with a FIGO stage IB tumor might be treated without groin surgery resulting in less treatment-related morbidity. The results are promising but more prospective data on a higher number of patients are necessary.

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Size of sentinel-node metastasis and chances of non-sentinel-node involvement and survival in early stage vulvar cancer: results from GROINSS-V, a multicentre observational study

Cited by 233 publications

References 20 publications

Lymph node metastases and prognosis in penile cancer

Lymph node metastases and prognosis in penile cancer

Can vascular endothelial growth factor C expression be of use in predicting surgical stage or prognosis in vulvar cancer ?

An alternative way to measure the depth of invasion of vulvar squamous cell carcinoma in relation to prognosis

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