Morbidity and quality of life in patients with vulvar cancer after inguinal sentinel lymphadenectomy compared to radical inguinofemoral lymphadenectomy

Author:

Thangarajah Fabinshy1,Rogeé Kristina2,Pahmeyer Caroline1,Kuhr Kathrin3,Schmidt Matthias4,Fridrich Claudius5,Morgenstern Bernd1

Affiliation:

1. Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany

2. Department of Gynecology and Obstetrics, GFO Clinic Rhein-Berg; Vinzenz-Pallotti-Hospital, Bergisch Gladbach-Bensberg, Germany

3. Institute of Medical Statistics and Computational Biology, University of Cologne, Germany

4. Department of Nuclear Medicine, University of Cologne, Germany

5. Department of Gynecology and Obstetrics, Heilig-Geist-Krankenhaus, Cologne, Germany

Abstract

Abstract Aim Probability of survival of patients with vulvar cancer directly depends on the lymph node status. Surgery of lymph nodes can be performed as radical inguinofemoral lymphadenectomy or in cases with certain conditions as sentinel lymph node surgery. The aim of this study is to obtain an overview of the intervention-related morbidity and quality of life in patients with vulvar carcinoma after lymphadenectomy. Methods Quality of life and morbidity was compared between patients who underwent radical inguinofemoral lymphadenectomy with those who underwent sentinel lymph node surgery. Results All recorded postoperative complications occur more frequently in the non-sentinel group, Significant difference was shown for the occurrence of lymphedema (p-value = 0.024) and sensitivity loss (p-value = 0.024). Recurrence of disease was more frequent in the non-sentinel group (38 % vs. 20 %, p = 0.621, n.s.) and satisfaction with groin surgery is slightly higher in the sentinel group (94 % vs. 89 %, p = 1.000, n.s.). Conclusion We could demonstrate a significantly lower morbidity of sentinel lymphadenectomy compared to conventional inguinofemoral lymphadenectomy while maintaining the same oncological safety. The low morbidity of sentinel- lymphadenectomy does not seem to influence the postoperative quality of life significantly. However, recording of the individual burden of lymphadenectomy by questionnaires should be optimized.

Publisher

Georg Thieme Verlag KG

Subject

Radiology Nuclear Medicine and imaging,General Medicine

Reference18 articles.

1. Vulvar cancer: epidemiology, clinical presentation, and management options;I Alkatout;Int J Womens Health,2015

2. Epidemiology of vulvar neoplasia in the NIH-AARP Study;L A Brinton;Gynecologic oncology,2017

3. Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva;J A de Hullu;Journal of clinical oncology: official journal of the American Society of Clinical Oncology,2000

4. The prognostic significance of micrometastases in node-negative squamous cell carcinoma of the vulva;G V Narayansingh;British journal of cancer,2005

5. Carcinoma of the vulva: analysis of treatment failures;K C Podratz;Am J Obstet Gynecol,1982

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