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

Area of Science:

• Oncology
• Surgical Oncology

Background:

• Inguinal sentinel lymph node dissection (SLND) is a recommended procedure for early vulvar cancer due to the poor prognosis of groin recurrence.
• High-quality standards are crucial for SLND to minimize false-negative rates and recurrence.
• This study evaluates the real-world incidence of isolated groin recurrence following SLND in Germany.

Purpose of the Study:

• To investigate the incidence of isolated groin recurrence in patients with early vulvar cancer undergoing SLND in routine clinical practice.
• To assess the impact of guideline-recommended quality requirements on recurrence rates.

Main Methods:

• Retrospective analysis of 414 patients with early vulvar cancer who underwent inguinal SLND between 2009 and 2015.
• Inclusion criteria: node-negative final histologic results.
• Data collected on disease stage, SLND procedure, and follow-up from cancer databases and patient registries.

Main Results:

• The overall isolated groin recurrence rate was 3.1% (13 of 414 patients) with a mean follow-up of 38.4 months.
• Mean tumor size was 40.0 mm.
• No statistically significant association was found between adherence to quality requirements (tumor size < 4 cm, unifocal tumor, histologic ultra-staging, preoperative exclusion of suspicious groins) and isolated groin recurrence.

Conclusions:

• Inguinal SLND is a safe procedure in the daily management of early vulvar cancer.
• Current guideline requirements for SLND in vulvar cancer may not significantly impact isolated groin recurrence rates in practice.
• Further research may be needed to refine quality standards for SLND in vulvar cancer.