The Risk of Contralateral Non-sentinel Metastasis in Patients with Primary Vulvar Cancer and Unilaterally Positive Sentinel Node
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The Risk of Contralateral Non-sentinel Metastasis in Patients with Primary Vulvar Cancer and Unilaterally Positive Sentinel Node. / Woelber, Linn; Eulenburg, Christine; Grimm, Donata; Trillsch, Fabian; Bohlmann, Inga; Burandt, Eike; Dieckmann, Jan; Klutmann, Susanne; Schmalfeldt, Barbara; Mahner, Sven; Prieske, Katharina.
In: ANN SURG ONCOL, Vol. 23, No. 8, 08.2016, p. 2508-14.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The Risk of Contralateral Non-sentinel Metastasis in Patients with Primary Vulvar Cancer and Unilaterally Positive Sentinel Node
AU - Woelber, Linn
AU - Eulenburg, Christine
AU - Grimm, Donata
AU - Trillsch, Fabian
AU - Bohlmann, Inga
AU - Burandt, Eike
AU - Dieckmann, Jan
AU - Klutmann, Susanne
AU - Schmalfeldt, Barbara
AU - Mahner, Sven
AU - Prieske, Katharina
PY - 2016/8
Y1 - 2016/8
N2 - BACKGROUND: In patients with primary vulvar cancer and bilateral sentinel lymph node (SLN) biopsy, bilateral complete inguino-femoral lymphadenectomy (LAE) is recommended, even in cases with only unilaterally positive SLN by most guidelines. The risk of contralateral non-SLN metastasis is unclear.METHODS: All patients with primary vulvar cancer receiving an SLN dissection with radioactive tracer ± blue dye at the University Medical Center Hamburg-Eppendorf between 2001 and 2013 were retrospectively evaluated. Median follow-up was 33 months.RESULTS: A total of 140 patients were included; 124 with bilateral and 16 with unilateral SLN dissection. A median number of two SLNs (range 1-7) per groin were dissected. Overall, 53 (53/140, 37.9 %) patients received a complete inguino-femoral LAE, 41 of whom (77.4 %) had previously presented with a positive SLN (33 unilaterally, 8 bilaterally). Of the 33 patients with unilaterally positive SLN, 28 (84.9 %) underwent complete bilateral inguino-femoral LAE despite a contralateral negative SLN. Of these patients, none presented a contralateral non-SLN metastasis (0/28, 0 %) in full dissection; however, one developed groin recurrence in the initially SLN-negative, fully dissected groin after 19 months (1/28, 3.6 %).CONCLUSION: In case of bilateral SLN biopsy for clinically node-negative disease and only unilaterally positive SLN, the risk for contralateral non-SLN metastases appears to be low. These data support the omission of contralateral LAE to reduce surgical morbidity.
AB - BACKGROUND: In patients with primary vulvar cancer and bilateral sentinel lymph node (SLN) biopsy, bilateral complete inguino-femoral lymphadenectomy (LAE) is recommended, even in cases with only unilaterally positive SLN by most guidelines. The risk of contralateral non-SLN metastasis is unclear.METHODS: All patients with primary vulvar cancer receiving an SLN dissection with radioactive tracer ± blue dye at the University Medical Center Hamburg-Eppendorf between 2001 and 2013 were retrospectively evaluated. Median follow-up was 33 months.RESULTS: A total of 140 patients were included; 124 with bilateral and 16 with unilateral SLN dissection. A median number of two SLNs (range 1-7) per groin were dissected. Overall, 53 (53/140, 37.9 %) patients received a complete inguino-femoral LAE, 41 of whom (77.4 %) had previously presented with a positive SLN (33 unilaterally, 8 bilaterally). Of the 33 patients with unilaterally positive SLN, 28 (84.9 %) underwent complete bilateral inguino-femoral LAE despite a contralateral negative SLN. Of these patients, none presented a contralateral non-SLN metastasis (0/28, 0 %) in full dissection; however, one developed groin recurrence in the initially SLN-negative, fully dissected groin after 19 months (1/28, 3.6 %).CONCLUSION: In case of bilateral SLN biopsy for clinically node-negative disease and only unilaterally positive SLN, the risk for contralateral non-SLN metastases appears to be low. These data support the omission of contralateral LAE to reduce surgical morbidity.
U2 - 10.1245/s10434-016-5114-6
DO - 10.1245/s10434-016-5114-6
M3 - SCORING: Journal article
C2 - 26856721
VL - 23
SP - 2508
EP - 2514
JO - ANN SURG ONCOL
JF - ANN SURG ONCOL
SN - 1068-9265
IS - 8
ER -