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GROINS V

Sentinel Lymph Node Dissection Is Safe in the Treatment of Early-Stage Vulvar Cancer

Date of Publication:

February 20, 2008

Pubmed Link:
https://pubmed.ncbi.nlm.nih.gov/18281661/
Hypothesis:

Is omitting inguinofemoral lymphadenectomy in patients with a negative sentinel node safe?

Control Arm(s):
Experimental Arm(s):

Radical excision of the primary tumor

SLN (radioactive tracer + blue dye)

If SLN negative on frozen, groin dissection omitted

If SLN positive, inguinofemoral lymphadenectomy performed

Primary End Point:

Groin recurrence rate

Inclusion Criteria:

SCC of vulva

Tumor < 4cm in size

Depth of invasion >1mm

Clinically nonsuspicious inguinofemoral lymph nodes

Exclusion Criteria:
Results:

n= 403 (623 groins):

LN metastasis: 26% (routine H&E detected 58%, ultrastaging detected remaining 42%)

SLN negative, uniforcal disease:

2yr groin recurrence: 2.3%

3 yr OS: 97%

Less mordibity in SLN - wound complications, lymphedema

Conclusions:

SLN only in early stage vulvar cancer does not compromise groin recurrence rates.

Reviewer:
Laurel K. Berry, OTF