Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe

GROINSS-V I and II participants; W. L. Van der Kolk; A. G.J. Van der Zee; B. M. Slomovitz; P. J.W. Baldwin; H. C. Van Doorn; J. A. De Hullu; J. Van der Velden; K. N. Gaarenstroom; B. F.M. Slangen; P. Kjolhede; M. Brännström; I. Vergote; C. M. Holland; R. Coleman; E. B.L. Van Dorst; W. J. Van Driel; D. Nunns; M. Widschwendter; D. Nugent; P. A. DiSilvestro; R. S. Mannel; M. Y. Tjiong; D. Boll; D. Cibula; A. Covens; D. Provencher; I. B. Runnebaum; B. J. Monk; V. Zanagnolo; K. Tamussino; M. H.M. Oonk

doi:10.1016/j.ygyno.2022.07.017

Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe

GROINSS-V I and II participants
, W. L. Van der Kolk
, A. G.J. Van der Zee
, B. M. Slomovitz
, P. J.W. Baldwin
, H. C. Van Doorn
, J. A. De Hullu
, J. Van der Velden
, K. N. Gaarenstroom
, B. F.M. Slangen
, P. Kjolhede
, M. Brännström
, I. Vergote
, C. M. Holland
, R. Coleman
, E. B.L. Van Dorst
, W. J. Van Driel
, D. Nunns
, M. Widschwendter
, D. Nugent

P. A. DiSilvestro, R. S. Mannel, M. Y. Tjiong, D. Boll, D. Cibula, A. Covens, D. Provencher, I. B. Runnebaum, B. J. Monk, V. Zanagnolo, K. Tamussino, M. H.M. Oonk^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

17 Citations (Scopus)

113 Downloads (Pure)

Abstract

Objective: Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN.

Methods: We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up.

Results: Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In eight patients (8/244; 3.3% [95% CI: 1.7%–6.3%]) disease was diagnosed in the contralateral groin: six had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after nu further treatment. Six of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8% [95% CI: 0.1%–4.5%]) had a contralateral groin recurrence.

Conclusion: The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases.

Original language	English
Journal	Gynecologic Oncology
Volume	167
Issue number	1
DOIs	https://doi.org/10.1016/j.ygyno.2022.07.017
Publication status	Published - Oct-2022

Keywords

Inguinofemoral lymphadenectomy
Lymph node metastases
Radiotherapy
Sentinel lymph node
Vulvar cancer

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GROINSS-V I and II participants, Van der Kolk, W. L., Van der Zee, A. G. J., Slomovitz, B. M., Baldwin, P. J. W., Van Doorn, H. C., De Hullu, J. A., Van der Velden, J., Gaarenstroom, K. N., Slangen, B. F. M., Kjolhede, P., Brännström, M., Vergote, I., Holland, C. M., Coleman, R., Van Dorst, E. B. L., Van Driel, W. J., Nunns, D., Widschwendter, M., ... Oonk, M. H. M. (2022). Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe. Gynecologic Oncology, 167(1). https://doi.org/10.1016/j.ygyno.2022.07.017

@article{eebc0bd5c42d4ba8a47815000d84b493,

title = "Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe",

abstract = "Objective: Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN.Methods: We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up.Results: Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In eight patients (8/244; 3.3\% [95\% CI: 1.7\%–6.3\%]) disease was diagnosed in the contralateral groin: six had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after nu further treatment. Six of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8\% [95\% CI: 0.1\%–4.5\%]) had a contralateral groin recurrence.Conclusion: The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases.",

keywords = "Inguinofemoral lymphadenectomy, Lymph node metastases, Radiotherapy, Sentinel lymph node, Vulvar cancer",

author = "\{GROINSS-V I and II participants\} and \{Van der Kolk\}, \{W. L.\} and \{Van der Zee\}, \{A. G.J.\} and Slomovitz, \{B. M.\} and Baldwin, \{P. J.W.\} and \{Van Doorn\}, \{H. C.\} and \{De Hullu\}, \{J. A.\} and \{Van der Velden\}, J. and Gaarenstroom, \{K. N.\} and Slangen, \{B. F.M.\} and P. Kjolhede and M. Br{\"a}nnstr{\"o}m and I. Vergote and Holland, \{C. M.\} and R. Coleman and \{Van Dorst\}, \{E. B.L.\} and \{Van Driel\}, \{W. J.\} and D. Nunns and M. Widschwendter and D. Nugent and DiSilvestro, \{P. A.\} and Mannel, \{R. S.\} and Tjiong, \{M. Y.\} and D. Boll and D. Cibula and A. Covens and D. Provencher and Runnebaum, \{I. B.\} and Monk, \{B. J.\} and V. Zanagnolo and K. Tamussino and Oonk, \{M. H.M.\} and Levenback, \{C. F.\} and Hermans, \{R. H.\} and J. Bouda and A. Sharma and D. Luesley and P. Ellis and Cruickshank, \{D. J.\} and Duncan, \{T. J.\} and K. Kieser and C. Palle and Spirtos, \{N. M.\} and O'Malley, \{D. M.\} and Leitao, \{M. M.\} and M. Geller and K. Dhar and V. Asher and Tobias, \{D. H.\} and C. Borgfeldt and Lea, \{J. S.\}",

note = "Funding Information: GROINSS-V II was funded by the Dutch Cancer Society . Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = oct,

doi = "10.1016/j.ygyno.2022.07.017",

language = "English",

volume = "167",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "ACADEMIC PRESS INC ELSEVIER SCIENCE",

number = "1",

}

GROINSS-V I and II participants, Van der Kolk, WL , Van der Zee, AGJ, Slomovitz, BM, Baldwin, PJW, Van Doorn, HC, De Hullu, JA, Van der Velden, J, Gaarenstroom, KN, Slangen, BFM, Kjolhede, P, Brännström, M, Vergote, I, Holland, CM, Coleman, R, Van Dorst, EBL, Van Driel, WJ, Nunns, D, Widschwendter, M, Nugent, D, DiSilvestro, PA, Mannel, RS, Tjiong, MY, Boll, D, Cibula, D, Covens, A, Provencher, D, Runnebaum, IB, Monk, BJ, Zanagnolo, V, Tamussino, K & Oonk, MHM 2022, 'Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe', Gynecologic Oncology, vol. 167, no. 1. https://doi.org/10.1016/j.ygyno.2022.07.017

Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe. / GROINSS-V I and II participants ; Van der Kolk, W. L.; Van der Zee, A. G.J. et al.
In: Gynecologic Oncology, Vol. 167, No. 1, 10.2022.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe

AU - GROINSS-V I and II participants

AU - Van der Kolk, W. L.

AU - Van der Zee, A. G.J.

AU - Slomovitz, B. M.

AU - Baldwin, P. J.W.

AU - Van Doorn, H. C.

AU - De Hullu, J. A.

AU - Van der Velden, J.

AU - Gaarenstroom, K. N.

AU - Slangen, B. F.M.

AU - Kjolhede, P.

AU - Brännström, M.

AU - Vergote, I.

AU - Holland, C. M.

AU - Coleman, R.

AU - Van Dorst, E. B.L.

AU - Van Driel, W. J.

AU - Nunns, D.

AU - Widschwendter, M.

AU - Nugent, D.

AU - DiSilvestro, P. A.

AU - Mannel, R. S.

AU - Tjiong, M. Y.

AU - Boll, D.

AU - Cibula, D.

AU - Covens, A.

AU - Provencher, D.

AU - Runnebaum, I. B.

AU - Monk, B. J.

AU - Zanagnolo, V.

AU - Tamussino, K.

AU - Oonk, M. H.M.

AU - Levenback, C. F.

AU - Hermans, R. H.

AU - Bouda, J.

AU - Sharma, A.

AU - Luesley, D.

AU - Ellis, P.

AU - Cruickshank, D. J.

AU - Duncan, T. J.

AU - Kieser, K.

AU - Palle, C.

AU - Spirtos, N. M.

AU - O'Malley, D. M.

AU - Leitao, M. M.

AU - Geller, M.

AU - Dhar, K.

AU - Asher, V.

AU - Tobias, D. H.

AU - Borgfeldt, C.

AU - Lea, J. S.

PY - 2022/10

Y1 - 2022/10

N2 - Objective: Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN.Methods: We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up.Results: Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In eight patients (8/244; 3.3% [95% CI: 1.7%–6.3%]) disease was diagnosed in the contralateral groin: six had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after nu further treatment. Six of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8% [95% CI: 0.1%–4.5%]) had a contralateral groin recurrence.Conclusion: The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases.

AB - Objective: Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN.Methods: We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. We determined the incidence of contralateral additional non-SN metastases in patients with unilateral SN-metastasis who underwent bilateral inguinofemoral lymphadenectomy (IFL). In those who underwent only ipsilateral groin treatment or no further treatment, we determined the incidence of contralateral groin recurrences during follow-up.Results: Of 1912 patients with early-stage VSCC, 366 had a unilateral metastatic SN. Subsequently, 244 had an IFL or no treatment of the contralateral groin. In eight patients (8/244; 3.3% [95% CI: 1.7%–6.3%]) disease was diagnosed in the contralateral groin: six had contralateral non-SN metastasis at IFL and two developed an isolated contralateral groin recurrence after nu further treatment. Six of them had a primary tumor ≥30 mm. Bilateral radiotherapy was administered in 122 patients, of whom one (1/122; 0.8% [95% CI: 0.1%–4.5%]) had a contralateral groin recurrence.Conclusion: The risk of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN is low. It appears safe to limit groin treatment to unilateral IFL or inguinofemoral radiotherapy in these cases.

KW - Inguinofemoral lymphadenectomy

KW - Lymph node metastases

KW - Radiotherapy

KW - Sentinel lymph node

KW - Vulvar cancer

U2 - 10.1016/j.ygyno.2022.07.017

DO - 10.1016/j.ygyno.2022.07.017

M3 - Article

AN - SCOPUS:85137390890

SN - 0090-8258

VL - 167

JO - Gynecologic Oncology

JF - Gynecologic Oncology

IS - 1

ER -

Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe

Abstract

Keywords

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