# GROINSS-V: sentinel node dissection is safe in early-stage vulvar cancer

Source: https://onco.cc/key-papers/paper-groinss-v-sentinel-node-vulvar-cancer-jco-2008/  
OnCo record `paper-groinss-v-sentinel-node-vulvar-cancer-jco-2008` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Removing only the first draining lymph node in the groin, and leaving the rest when it was clear, was safe for women with small vulvar cancers: very few groins relapsed and the swelling and wound problems of full groin surgery were largely avoided.

## Summary

Prospective multicentre observational study of 403 women with unifocal vulvar squamous cell carcinoma under 4 cm and clinically negative groins who had sentinel node detection with radiotracer and blue dye; inguinofemoral lymphadenectomy was omitted when the sentinel node was negative.

Groin recurrence occurred in 2.3 percent of women with a negative sentinel node, three-year survival was 97 percent, and wound breakdown, infection and lymphoedema were far less common than after full lymphadenectomy. The procedure became the standard for early vulvar cancer.

## Fields

- Kind: Key paper
- Last checked: 2026-09-18
- Journal: Journal of Clinical Oncology
- Year: 2008
- DOI: 10.1200/JCO.2007.14.0566
- Authors: Van der Zee AG, Oonk MH, De Hullu JA, et al.
- Findings: Groin recurrence in 2.3 percent of sentinel-node-negative women; three-year disease-specific survival 97 percent.; Short-term wound complications and lymphoedema much less frequent than after inguinofemoral lymphadenectomy.
- What it means: Women with small, unifocal vulvar cancers and clinically negative groins can be staged with a sentinel node procedure and spared full groin dissection when the node is clear.
- Caveats: Applies only to unifocal tumours under 4 cm with clinically negative groins, in centres experienced in the technique.; Not randomised against lymphadenectomy.

## Sources

- J Clin Oncol 2008: https://doi.org/10.1200/JCO.2007.14.0566
- PubMed: https://pubmed.ncbi.nlm.nih.gov/18281661/

## Connected records

- cancers: [HPV-associated vulvar squamous cell carcinoma](https://onco.cc/cancers/hpv-associated-vulvar-cancer/), [HPV-independent vulvar squamous cell carcinoma (p53-mutant)](https://onco.cc/cancers/hpv-independent-vulvar-cancer/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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