Node count and groin recurrence in early vulvar cancer: A Gynecologic Oncology Group study

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• 作者：Frederick B. Stehman ; Shamshad Ali ; Philip J. DiSaia
• 关键词：Vulvar cancer ; Inguinal nodes ; Node count
• 刊名：Gynecologic Oncology
• 出版年：2009
• 出版时间：April 2009
• 年：2009
• 卷：113
• 期：1
• 页码：52-56
• 全文大小：354 K

文摘

Objective

To determine if low node count from superficial groin dissection correlated with first recurrence in the groin for patients with early vulvar cancer.

Methods

The Gynecologic Oncology Group (GOG) conducted a trial for patients with early stage squamous vulvar cancer, lesions < 2 cm in size and < 5 mm in depth. All fatty tissue below the inguinal ligament, medial to the sartorious and lateral to the adductor longus was removed. Incision of the fascia and skeletonizing the femoral vessels were not required. For this secondary analysis, we reviewed the records of all patients to assess node counts.

Results

Of the 113 patients eligible for the study, 104 patients (with 117 dissected groins) did not have a first recurrence in the groin. The median number of negative nodes was 9 (range: 1–26). Nine patients (with 9 dissected groins) suffered a first recurrence in the groin. The median number of negative nodes removed per groin was 7 (range: 4–22). There were no significant differences between patients with first recurrence in the groin and those without (p value = 0.7475). There was a broad overlap of the confidence intervals.

Conclusions

We were unable to show that groin failure after superficial lymphadenectomy was a result of low lymph node count. The small number of recurrences made firm conclusions impossible. Variations in anatomy and other factors may make node counting an unreliable measure of surgical quality.