The purpose of this research was to evaluate whether or not women who underwent superficial or deep inguinal lymph node dissections for suspected early-stage vulvar cancer had a higher rate of groin recurrence. Overall survival and postoperative morbidity were secondary outcomes compared across the study groups. In this retrospective study, researchers looked at data from 233 individuals diagnosed with vulvar squamous cell carcinoma (SCC) and treated with inguinal lymph node dissection between 1999 and 2017 at 2 major academic centers. A total of 400 groin node dissections were studied, together with demographic, surgical, recurrence, survival, and post-operative morbidity data for 233 individuals. Similarly low rates of inguinal recurrence (3.4% vs 8.3%, P=0.16) and total primary recurrence of illness (42.5 vs 39.8%, P=0.70) were seen comparing superficial and deep inguinal LND. Compared to the cohort that did not have deep LND, those who did had considerably higher rates of postoperative morbidity (70.3% vs 44.3%, P<0.01). Patients who underwent deep LND had significantly higher rates of lymphedema (42.4 vs 15.9%, P<0.01), readmission (26.3 vs 6.8%, P<0.01), and infection (40.7 vs. 14.8%, P<0.01). After taking into account differences in study groups’ stages and ages, there was no discernible difference in overall survival (HR 1.08, P=0.84). Patients with vulvar SCC who underwent superficial as opposed to deep inguinal LND did not fare significantly better in terms of recurrence rate or overall survival. Overall morbidity, including lymphedema, readmission, and infection, was significantly higher among those who had undergone extensive LND. Patients who were unable to undergo or who failed sentinel lymph node mapping might still benefit from a superficial inguinal lymph node dissection, which has been shown to have similar outcomes in recurrence and overall survival to a complete, or deep, lymph node dissection, but with less overall morbidity.
Source: sciencedirect.com/science/article/pii/S0090825822004280
