Risk for Pelvic Metastasis and Role of Pelvic Lymphadenectomy in Node-Positive Vulvar Cancer-Results from the AGO-VOP.2 QS Vulva Study.

Autor: Woelber L; Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.; Colposcopy Center at the Jerusalem Hospital Hamburg, 20357 Hamburg, Germany., Hampl M; Department of Gynecology, University Medical Center Duesseldorf, 40225 Duesseldorf, Germany., Eulenburg CZ; Department of Epidemiology, UMCG, Universität Groningen, 9713 Groningen, The Netherlands., Prieske K; Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.; Colposcopy Center at the Jerusalem Hospital Hamburg, 20357 Hamburg, Germany.; Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany., Hambrecht J; Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany., Fuerst S; Department of Obstetrics and Gynecology, University Hospital, LMU-University of Munich, 80377 Munich, Germany., Klapdor R; Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany., Heublein S; Department of Obstetrics and Gynecology, University Hospital Heidelberg, 69120 Heidelberg, Germany., Gass P; Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany., Rohner A; Department of Gynecology, University Medical Center Tuebingen, 72076 Tuebingen, Germany., Canzler U; Department of Gynecology and Obstetrics, University Hospital Dresden, Technische Universität Dresden, Dresden, Germany & National Center for Tumor Diseases (NCT), Partner Site Dresden, 01307 Dresden, Germany., Becker S; Department of Gynecology and Obstetrics, University Medical Center Frankfurt, 60590 Frankfurt, Germany., Bommert M; Department of Gynecology and Gynecologic Oncology, Evang. Kliniken Essen-Mitte, 45136 Essen, Germany., Bauerschlag D; Department of Gynecology, University Medical Center Kiel, 24105 Kiel, Germany., Denecke A; Department of Gynecology, Medical Center Wolfsburg, 38440 Wolfsburg, Germany., Hanker L; Department of Gynecology and Gynecologic Oncology, University Medical Center Luebeck, 23562 Luebeck, Germany., Runnebaumn I; Department of Gynecology, Jena University Hospital, 07743 Jena, Germany., Forner DM; Department of Gynecology, Evangelisches Krankenhaus Kalk, 51103 Cologne, Germany., Schochter F; Department of Obstetrics and Gynecology, University of Ulm Medical Center, 89081 Ulm, Germany., Klar M; Department of Gynecology, University Medical Center Freiburg, 79106 Freiburg, Germany., Schwab R; Department of Gynecology, University Medical Center Mainz, 55131 Mainz, Germany., Koepke M; Department of Obstetrics and Gynaecology, University Hospital Augsburg, 86156 Augsburg, Germany., Kalder M; Department of Gynecology and Obstetrics, University Hospital Marburg, 35043 Marburg, Germany., Hantschmann P; Department of Gynecology and Obstetrics, Medical Center Altoetting, 84503 Altoetting, Germany., Ratiu D; Department of Gynecology, University Medical Center Koeln, 50937 Koeln, Germany., Denschlag D; Department of Gynecology, Hochtaunuskliniken, 61352 Bad Homburg, Germany., Schroeder W; Department of Gynecology, Medical Center Gynaecologicum Bremen, 28209 Bremen, Germany., Tuschy B; Department of Gynecology, University Medical Center Mannheim, 68167 Mannheim, Germany., Baumann K; Department of Gynecology, Medical Center Ludwigshafen, 67063 Ludwigshafen, Germany., Mustea A; Department of Gynecology and Gynecologic Oncology, University Medical Center Bonn, 53127 Bonn, Germany., Soergel P; Department of Gynecology, University Medical Center Minden, 32429 Minden, Germany., Bronger H; Department of Gynecology and Obstetrics, Technical University of Munich, 81675 Munich, Germany., Bauerschmitz G; Department of Gynecology, University Medical Center Goettingen, 37075 Goettingen, Germany., Kosse J; Department of Gynecology, Sana Klinikum Offenbach, 63069 Offenbach am Main, Germany., Koch MC; Department of Gynecology, Medical Center Ansbach, 91522 Ansbach, Germany., Ignatov A; Department of Obstetrics and Gynecology, University Hospital Magdeburg, 39120 Magdeburg, Germany., Sehouli J; Department of Gynecology with Center for Oncological SurgeryNOGGO e.V., Charite Universitatsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, Germany., Dannecker C; Department of Obstetrics and Gynaecology, University Hospital Augsburg, 86156 Augsburg, Germany., Mahner S; Department of Obstetrics and Gynecology, University Hospital, LMU-University of Munich, 80377 Munich, Germany., Jaeger A; Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2022 Jan 14; Vol. 14 (2). Date of Electronic Publication: 2022 Jan 14.
DOI: 10.3390/cancers14020418
Abstrakt: The need for pelvic treatment in patients with node-positive vulvar cancer (VSCC) and the value of pelvic lymphadenectomy (LAE) as a staging procedure to plan adjuvant radiotherapy (RT) is controversial. In this retrospective, multicenter analysis, 306 patients with primary node-positive VSCC treated at 33 gynecologic oncology centers in Germany between 2017 and 2019 were analyzed. All patients received surgical staging of the groins; nodal status was as follows: 23.9% (73/306) pN1a, 23.5% (72/306) pN1b, 20.4% (62/306) pN2a/b, and 31.9% (97/306) pN2c/pN3. A total of 35.6% (109/306) received pelvic LAE; pelvic nodal involvement was observed in 18.5%. None of the patients with nodal status pN1a or pN1b and pelvic LAE showed pelvic nodal involvement. Taking only patients with nodal status ≥pN2a into account, the rate of pelvic involvement was 25%. In total, adjuvant RT was applied in 64.4% (197/306). Only half of the pelvic node-positive (N+) patients received adjuvant RT to the pelvis (50%, 10/20 patients); 41.9% (122/291 patients) experienced recurrent disease or died. In patients with histologically-confirmed pelvic metastases after LAE, distant recurrences were most frequently observed (7/20 recurrences). Conclusions: A relevant risk regarding pelvic nodal involvement was observed from nodal status pN2a and higher. Our data support the omission of pelvic treatment in patients with nodal status pN1a and pN1b.
Databáze: MEDLINE
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