Journal article
Is bilateral lymphadenectomy for midline squamous carcinoma of the vulva always necessary? An analysis from Gynecologic Oncology Group (GOG) 173
Gynecologic oncology, Vol.128(2), pp.155-159
02/01/2013
DOI: 10.1016/j.ygyno.2012.11.034
PMCID: PMC3638213
PMID: 23201592
Abstract
Objective: To determine which patients with near midline lesions may safely undergo unilateral groin dissection based on clinical exam and lymphoscintigraphy (LSG) results.
Methods: Patients participating in GOG-173 underwent sentinel lymph node (SLN) localization with blue dye, and radiocolloid with optional LSG before definitive inguinal-femoral lymphadenectomy (LND). This analysis interrogates the reliability of LSG alone relative to primary tumor location in those patients who had an interpretable LSG and at least one SLN identified. Primary tumor location was categorized as lateral (>2cm from midline), midline, or lateral ambiguous (LA) if located within 2cm, but not involving the midline.
Results: Two-hundred-thirty-four patients met eligibility criteria. Sixty-four had lateral lesions, and underwent unilateral LND. All patients with LA (N=65) and midline (N=105) tumors underwent bilateral LND. Bilateral drainage by LSG was identified in 14/64 (22%) patients with lateral tumors, 38/65 (58%) with LA tumors and in 73/105 (70%) with midline tumors. At mapping, no SLNs were found in contralateral groins among those patients with LA and midline tumors who had unilateral-only LSGs. However, in these patients groin metastases were found in 4/32 patients with midline tumors undergoing contralateral dissection; none were found in 27 patients with LA tumors.
Conclusion: The likelihood of detectable bilateral drainage using preoperative LSG decreases as a function of distance from midline. Patients with LA primaries and unilateral drainage on LSG may safely undergo unilateral SLN.
Details
- Title: Subtitle
- Is bilateral lymphadenectomy for midline squamous carcinoma of the vulva always necessary? An analysis from Gynecologic Oncology Group (GOG) 173
- Creators
- Samuel S. LentzJames J. Burke IIRobert L. ColemanShamshad AliNick M. SpirtosMaria C. BellKoen De Geest - University of IowaCharles F. LevenbackRonald K. PotkulEmma C. RossiMario M. Leitao Jr.Jeffrey M. FowlerPatricia L. JudsonMichael A. GoldLinda Van LeCornelia L. TrimbleJamie N. Bakkum-Gamez
- Resource Type
- Journal article
- Publication Details
- Gynecologic oncology, Vol.128(2), pp.155-159
- DOI
- 10.1016/j.ygyno.2012.11.034
- PMID
- 23201592
- PMCID
- PMC3638213
- NLM abbreviation
- Gynecol Oncol
- ISSN
- 0090-8258
- Grant note
- DOI: 10.13039/100000054, name: National Cancer Institute, award: CA 27469, CA 37517
- Language
- English
- Date published
- 02/01/2013
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9983557492002771
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