Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-25T22:36:08.292Z Has data issue: false hasContentIssue false

Debate 48B - Should the Subsequent Management of Patients with Vulvar Cancer and a Positive Sentinel Lymph Node be Complete Groin Lymph Node Dissection or Radiation Therapy?

Radiation Therapy

from Section VI - Vaginal and Vulvar Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
Get access

Summary

Sentinel lymph node (SLN) biopsy is now the standard of care over inguinofemoral lymphadenectomy (IFL) in properly selected patients with early-stage squamous cell carcinoma (SCC) of the vulva. Patients with negative SLN do well without further intervention. However, a standardized treatment paradigm following the findings of a positive SLN remains lacking. Based on results from the GROINSS-V-II trial, patients with a micrometastasis of ≤2 mm receiving adjuvant inguinofemoral radiation therapy had a two-year ipsilateral isolated groin recurrence rate of 1.6%, and can avoid the morbidity of complete inguinofemoral lymphadenectomy (IFL). The approach for patients with SLN macrometastases (>2 mm) remains undefined – if such patients are treated without further IFL, careful attention to radiation treatment planning, dose, and the addition of concurrent cisplatin-based chemotherapy should be considered.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Cancer Society. Cancer Facts & Figures 2022. Atlanta, GA: American Cancer Society, 2022.Google Scholar
Van der Zee, AG, et al. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol 2008;26(6):884889.CrossRefGoogle ScholarPubMed
Te Grootenhuis, NC, et al. Sentinel nodes in vulvar cancer: long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I. Gynecol Oncol 2016;140(1):814.CrossRefGoogle Scholar
Levenback, CF, et al. Lymphatic mapping and sentinel lymph node biopsy in women with squamous cell carcinoma of the vulva: a Gynecologic Oncology Group study. J Clin Oncol 2012;30(31):37863791.CrossRefGoogle ScholarPubMed
Oonk, MHM, et al. Radiotherapy versus inguinofemoral lymphadenectomy as treatment for vulvar cancer patients with micrometastases in the sentinel node: results of GROINSS-V II. J Clin Oncol 2021;39(32):36233632.CrossRefGoogle ScholarPubMed
Glaser, S, et al. Inguinal nodal radiotherapy for vulvar cancer: are we missing the target again? Gynecol Oncol 2014;135(3):583585.CrossRefGoogle Scholar
Montana, GS, et al. Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a Gynecologic Oncology Group study. Int J Radiat Oncol Biol Phys 2000;48(4):10071013.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×