A study of recurrence, complication and survival rates in patients with early stage vulval cancer undergoing sentinel lymph node sampling: a single-centre experience

Arch Gynecol Obstet. 2023 Aug;308(2):561-567. doi: 10.1007/s00404-023-06968-z. Epub 2023 Feb 28.

Abstract

Purpose: Groin sentinel lymph node (SLN) identification and removal has become a standard of care for women with clinical early stage vulval cancer. There is evidence to support safe detection of the SLN with minimal morbidity. The purpose of this study is to report our experience of managing patients focusing on patient selection, adverse events, quality assurance of the procedure and any benefits and/or disadvantages to patients.

Methods: This was a retrospective study of patients with clinical early stage vulval cancer in a cancer centre over 5 years. Notes and hospital data were reviewed including admissions to emergency departments. Statistical software was used for the statistical analysis and the Kaplan Meier survival curve was generated to present survival rates.

Results: 61 cases were analysed. A total of 156 nodes have been removed and positive nodes were identified in 14 cases. In total, 9 women (14.75%) had disease recurrence within 5 years from primary surgery. Overall, 4 patients (6.5%) developed groin recurrence. In 3 of these patients there was isolated groin recurrence (4.9%). The median length of admission was 3 days and 6 cases were managed as day cases.

Conclusions: Since the closure of the GROINNS-2 trial we have continued the procedure of SLN identification for women with clinical early stage vulval cancer. We have shown high level of adherence to our protocol and survival and complication rates comparable to other studies on the same field. There were a few patients managed as day-case which was of benefit to the patients.

Keywords: Recurrence rates; Vulval cancer survival.

MeSH terms

  • Female
  • Humans
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / pathology
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy / adverse effects
  • Sentinel Lymph Node Biopsy / methods
  • Sentinel Lymph Node* / pathology
  • Sentinel Lymph Node* / surgery
  • Survival Rate
  • Vulvar Neoplasms* / pathology
  • Vulvar Neoplasms* / surgery