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

Frederick B. Stehman, Shamshad Ali, Philip J. DiSaia

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)52-56
Number of pages5
JournalGynecologic Oncology
Volume113
Issue number1
DOIs
StatePublished - Apr 1 2009

Keywords

  • Inguinal nodes
  • Node count
  • Vulvar cancer

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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