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The number of removed lymph nodes by inguinofemoral lymphadenectomy: impact on recurrence rates in patients with vulva carcinoma

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Inguinal lymph node (LN) metastasis is a crucial prognostic factor in vulva carcinoma. The aim of this study was to determine the prognostic value of the number of resected LNs in patients with vulvar carcinoma on recurrence rates.

Methods

This retrospective study includes patients with vulvar squamous cell carcinoma who underwent inguinofemoral lymphadenectomy (IFL) between 1998 and 2011. Dissected groins were stratified by the number of removed lymph nodes (<6 LNs versus ≥6 LNs) or inguinal LN metastasis (pN− versus pN+) and analyzed according to groin, local and distance recurrence rates.

Results

In total 45 patients were identified and 79 groins were eligible for this analysis. 11 patients underwent ipsilateral IFL and 34 bilateral IFL. The median age was 58 years (range 31–80). The median tumor size was 2 cm (range 0.1–7.9). A median of 8 (range 0–19) LNs were resected per groin. Overall in 11 groins LN metastases were found. Groin recurrences occurred in four patients, local recurrence in six patients and distant metastasis in one patient. We did not observe any significant improvement in groin recurrence rates, local recurrence rates and distant recurrence rates if more than six LNs were removed per groin. Notably, patients with LN metastasis did not show higher recurrence rates compared to unaffected LNs.

Conclusion

In this cohort we demonstrated that resection of more than six LNs per groin does not improve the recurrence rates in patients with carcinoma of the vulva. Further prospective studies with more individuals are needed to evaluate the role of resected LNs in vulvar carcinoma.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Hospital of Cologne, Kerpener Str. 34, 50931, Cologne, Germany

    Anja Diehl, Verena Kirn, Fabinshy Thangarajah, Thomas Einzmann, Marina Wirtz, Dominik Ratiu, Bernd Morgenstern, Claudius Fridrich, Peter Mallmann & Julian Puppe

  2. Department of Pediatric Oncology and Hematology, Children’s Hospital, University of Cologne, 50924, Cologne, Germany

    Ruth Volland

  3. Breast Center, Holweide Hospital, 51067, Cologne, Germany

    Christian Eichler

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  1. Anja Diehl
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  2. Ruth Volland
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Corresponding author

Correspondence to Julian Puppe.

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Conflict of interest

The authors declare that they have no conflict of interest. The authors did not receive any funding from the National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other. The authors declare that they have full control of all primary data and agree to allow the Journal to review their data if requested.

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404_2015_3932_MOESM1_ESM.ppt

Supplementary material 1 (PPT 130 kb) Supp. Figure 1: Recurrence rates based on the number of removed lymph nodes per patient: <12 (n=12) or ≥12 (n=21); (a) Groin recurrence (GR). (b) Local recurrence (LR). (c) Distant recurrence (DR).

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Diehl, A., Volland, R., Kirn, V. et al. The number of removed lymph nodes by inguinofemoral lymphadenectomy: impact on recurrence rates in patients with vulva carcinoma. Arch Gynecol Obstet 294, 131–136 (2016). https://doi.org/10.1007/s00404-015-3932-6

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  • DOI: https://doi.org/10.1007/s00404-015-3932-6

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