GROINSS-V: sentinel node dissection is safe in early-stage vulvar cancer
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.
Overview
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.
- 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.
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.
- Applies only to unifocal tumours under 4 cm with clinically negative groins, in centres experienced in the technique.
- Not randomised against lymphadenectomy.
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