학술논문
Sentinel nodes in vulvar cancer: Long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I.
Document Type
Article
Author
te Grootenhuis, N. C.; van der Zee, A. G. J.; van Doorn, H. C.; van der Velden, J.; Vergote, I.; Zanagnolo, V.; Baldwin, P. J.; Gaarenstroom, K. N.; van Dorst, E. B.; Trum, J. W.; Slangen, B. F. M.; Runnebaum, I. B.; Tamussino, K.; Hermans, R. H.; Provencher, D. M.; de Bock, G. H.; de Hullu, J. A.; Oonk, M. H. M.
Source
Subject
*VULVAR cancer
*SENTINEL lymph nodes
*CANCER invasiveness
*LYMPHADENECTOMY
*LONG-term care facilities
*CLINICAL trials
*FOLLOW-up studies (Medicine)
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Language
ISSN
0090-8258
Abstract
Objective. In 2008 GROINSS-V-I, the largest validation trial on the sentinel node (SN) procedure in vulvar cancer, showed that application of the SN-procedure in patients with early-stage vulvar cancer is safe. The current study aimed to evaluate long-term follow-up of these patients regarding recurrences and survival. Methods. From 2000 until 2006 GROINSS-V-I included 377 patients with unifocal squamous cell carcinoma of the vulva (T1, <4 cm), who underwent the SN-procedure. Only in case of SN metastases an inguinofemoral lymphadenectomy was performed. For the present study follow-up was completed until March 2015. Results. The median follow-up was 105 months (range 0-179). The overall local recurrence ratewas 27.2% at 5 years and 39.5% at 10 years after primary treatment, while for SN-negative patients 24.6% and 36.4%, and for SN-positive patients 33.2% and 46.4% respectively (p = 0.03). In 39/253 SN-negative patients (15.4%) an inguinofemoral lymphadenectomy was performed, because of a local recurrence. Isolated groin recurrence rate was 2.5% for SN-negative patients and 8.0% for SN-positive patients at 5 years. Disease-specific 10-year survival was 91% for SN-negative patients compared to 65% for SN-positive patients (p < .0001). For all patients, 10-year disease-specific survival decreased from 90% for patients without to 69% for patients with a local recurrence (p < .0001). Conclusions. Survival is very good for patientswith a negative SN, but still 36% of these patients, aswell as 46% of the patientswith a positive SN,will have a local recurrence. Although a local recurrence is treatedwith curative intent, the disease-specific survival of these patients decreases signi?cantly. [ABSTRACT FROM AUTHOR]