TY - JOUR
T1 - Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer
T2 - a Dutch nationwide study
AU - Pleunis, Noortje
AU - Pouwer, Anne-Floor W.
AU - Oonk, Maaike H. M.
AU - van Doorn, Helena C.
AU - Tjiong, Ming Y.
AU - van der Velden, Jacobus
AU - Zijlmans, Henry
AU - van Poelgeest, Mariette I. E.
AU - van Dorst, Eleonora B.
AU - Slangen, Brigitte F. M.
AU - Verhoef, Lia C. G.
AU - Pijnenborg, Johanna M. A.
AU - de Hullu, Joanne A.
N1 - Funding Information: Published conference abstracts: in an earlier stage of the study, the abstract was presented at the European Society of Gynecological Oncology (ESGO) meeting in 2019 [30]. Additional contributions: Martijn Mensink, Anouk van Heertum and Anne Hompesch are medical (Master of Science) students and were involved in the data collection process as part of their thesis. Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/10/5
Y1 - 2023/10/5
N2 - Background: Up to 40% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors. Methods: A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N−) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed. Results: Overall, 16.3% (66/404) had a N+ groin status at first local recurrence, 66.4% (268/404) N− and 17.3% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5% and 13.8%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9%; P = 0.050) at local recurrence. Conclusions: The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.
AB - Background: Up to 40% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors. Methods: A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N−) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed. Results: Overall, 16.3% (66/404) had a N+ groin status at first local recurrence, 66.4% (268/404) N− and 17.3% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5% and 13.8%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9%; P = 0.050) at local recurrence. Conclusions: The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.
UR - http://www.scopus.com/inward/record.url?scp=85170254555&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41416-023-02373-0
DO - https://doi.org/10.1038/s41416-023-02373-0
M3 - Article
C2 - 37507545
SN - 0007-0920
VL - 129
SP - 956
EP - 964
JO - British journal of cancer
JF - British journal of cancer
IS - 6
ER -