Sentinel Lymphonodectomy in Early Vulvar Cancer in Daily Practice: a Multicenter Experience from Germany.

IF 2.4 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Geburtshilfe Und Frauenheilkunde Pub Date : 2025-03-25 eCollection Date: 2025-05-01 DOI:10.1055/a-2541-2191
Philipp Soergel, Matthias Hempel, Julia Gallwas, Christian Dannecker, Linn Woelber, Ruediger Klapdor, Peer Hantschmann, Dirk M Forner, Paul Gass, Monika Hampl
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引用次数: 0

Abstract

Objective: Inguinal sentinel lymph node dissection has been shown to be safe in early vulvar cancer in several studies and is considered or even recommended in many guidelines. The prognosis of inguinal recurrence is often poor and associated with significant mortality. To ensure an acceptably low false-negative rate and recurrence, vulvar sentinel lymph node dissection should only be performed using high-quality standards. This retrospective study aims to investigate the incidence of isolated groin recurrence in daily practice in six large cancer centers in Germany.

Methods: We identified all patients with early vulvar cancer in 2009-2015 who underwent inguinal sentinel lymphonodectomy and presented with node-negative final histologic results. Patient details regarding disease stage, sentinel procedure, and follow-up were examined using local cancer databases and patient registries.

Results: A total of 414 patients with available follow-up data were found, with a mean follow-up time of 38.4 months. The mean tumor size, measured in the dermal plane before surgery, was 40.0 mm, with a median tumor size of 36 mm. Isolated groin recurrence was found in 13 of 414 cases, leading to an isolated groin recurrence rate of 3.1%. The mean time to isolated groin recurrence was 17.7 months. There was no statistically significant association of any of the different quality requirements (tumor size < 4 cm, unifocal tumor, histologic ultra-staging, and preoperative exclusion of suspicious groins) with isolated groin recurrence.

Conclusion: Sentinel lymphadenectomy in vulvar cancer is a safe procedure in daily practice. The requirements of the cancer guidelines (unifocal tumor, ≤ 4 cm, histologic ultrastaging, and exclusion of suspicious groins preoperatively) should be followed to ensure a low isolated groin recurrence rate. However, in this study, we could not find any difference between the patients who fulfilled the guideline requirements and those who did not.

早期外阴癌前哨淋巴结切除术的日常实践:来自德国的多中心经验。
目的:一些研究表明腹股沟前哨淋巴结清扫在早期外阴癌中是安全的,并且在许多指南中被考虑甚至推荐。腹股沟复发的预后通常很差,并伴有显著的死亡率。为了确保可接受的低假阴性率和复发率,外阴前哨淋巴结清扫应该只使用高质量的标准进行。本回顾性研究旨在调查在德国六个大型癌症中心的日常实践中孤立腹股沟复发的发生率。方法:选取2009-2015年间所有行腹股沟前哨淋巴结切除术且最终组织学结果为淋巴结阴性的早期外阴癌患者。使用当地癌症数据库和患者登记处检查有关疾病分期、前哨手术和随访的患者详细信息。结果:共有414例患者可获得随访资料,平均随访时间38.4个月。术前在真皮平面测量的平均肿瘤大小为40.0 mm,中位肿瘤大小为36 mm。414例中有13例腹股沟孤立性复发,导致腹股沟孤立性复发率3.1%。腹股沟孤立性复发的平均时间为17.7个月。结论:外阴癌前哨淋巴结切除术在日常实践中是一种安全的手术。应遵循肿瘤指南的要求(单灶性肿瘤,≤4 cm,组织学超调,术前排除可疑腹股沟),以确保低孤立性腹股沟复发率。然而,在本研究中,我们没有发现满足指南要求的患者与未满足指南要求的患者之间有任何差异。
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来源期刊
Geburtshilfe Und Frauenheilkunde
Geburtshilfe Und Frauenheilkunde 医学-妇产科学
CiteScore
2.50
自引率
22.20%
发文量
828
审稿时长
6-12 weeks
期刊介绍: Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.
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