The Importance of the Groin Node Status for the Survival of T1 and T2 Vulval Carcinoma Patients

Burger, M. P. M.; Hollema, Harry; Emanuels, A; Krans, M.; Pras, Elisabeth; Bouma, J

doi:10.1006/gyno.1995.1151

Cited by 203 publications

(91 citation statements)

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“…Results from the studies regarding prognostic factors for prognostic factors in vulvar cancer are contraversial and can be explained by small sample size included in the retsopective studies and heterogenous treatment approaches (Iversen et al, 1980;Burger et al, 1995;Gonzalez et al, 2005). Potential risk factors for vulvar rancer recurrences include stage, tumour size, depth of invasion, tumor free margin, lymphovascular space invasion, age and nodal involvement.…”

Section: Discussionmentioning

confidence: 99%

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

Stankeviča

Macuks²,

Baidekalna³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 99%

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

Stankeviča

Macuks²,

Baidekalna³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…One patient did not have lymph node dissection because of stage IA vulvar cancer. In literature, unexpected groin relapses were found in 5-7% of patients with negative inguinofemoral lymph nodes after inguinofemoral lymphadenectomy by separate incisions [8,24,25], which appears to be a substantial increase in the number of groin recurrences compared with the en bloc approach [8,26]. Gordenier et al [27] and Katz et al [28] also found 9% and 16% groin recurrences.…”

Section: Discussionmentioning

confidence: 99%

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

Woolderink

Bock

Hullu

et al. 2006

Gynecologic Oncology

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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.

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“…Recurrences were registered as local, groin, skin bridge, pelvic, or distant. To be capable of comparing both groups with respect to recurrence rates, two check points of evaluation of recurrences were used for this study: 2 years after primary treatment (because, based on the literature, most nonlocal recurrences develop within 2 years 19,24 ) and 4 years after primary treatment (because the last patient from Group II who was analyzed for the current study was treated 4 years before the date of the final analysis).…”

Section: Follow-upmentioning

confidence: 99%

“…In a previous study from our institute, we reported on the outcome of patients with vulvar carcinoma who were diagnosed between 1982 and 1992 with primary T1 and T2 tumors and who were treated with standard, radical vulvectomy with en bloc inguinofemoral lymphadenectomy. 19 In 1993, a radical change to more individualized treatment was made by essentially the same team of gynecologic oncologists. The objective of the current study was to analyze the consequences of these treatment modifications with respect to recurrence rates and survival.…”

mentioning

confidence: 99%

Vulvar carcinoma

Hullu

Hollema²,

Lolkema³

et al. 2002

Cancer

246

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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

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The Importance of the Groin Node Status for the Survival of T1 and T2 Vulval Carcinoma Patients

Cited by 203 publications

References 0 publications

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

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

Vulvar carcinoma

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