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

Woelber, Linn; Hampl, Monika; Eulenburg, Christine Zu; Prieske, Katharina; Hambrecht, Johanna; Fuerst, Sophie; Klapdor, Ruediger; Heublein, Sabine; Gass, Paul; Rohner, Annika; Canzler, Ulrich; Becker, Sven; Bommert, Mareike; Bauerschlag, Dirk; Denecke, Agnieszka; Hanker, Lars; Runnebaumn, Ingo; Forner, Dirk M; Schochter, Fabienne; Klar, Maximilian; Schwab, Roxana; Koepke, Melitta; Kalder, Matthias; Hantschmann, Peer; Ratiu, Dominik; Denschlag, Dominik; Schroeder, Willibald; Tuschy, Benjamin; Baumann, Klaus; Mustea, Alexander; Soergel, Philipp; Bronger, Holger; Bauerschmitz, Gerd; Kosse, Jens; Koch, Martin C; Ignatov, Atanas; Sehouli, Jalid; Dannecker, Christian; Mahner, Sven; Jaeger, Anna     «

Woelber, Linn; Hampl, Monika; Eulenburg, Christine Zu; Prieske, Katharina; Hambrecht, Johanna; Fuerst, Sophie; Klapdor, Ruediger; Heublein, Sabine; Gass, Paul; Rohner, Annika; Canzler, Ulrich; Becker, Sven; Bommert, Mareike; Bauerschlag, Dirk; Denecke, Agnieszka; Hanker, Lars; Runnebaumn, Ingo; Forner, Dirk M; Schochter, Fabienne; Klar, Maximilian; Schwab, Roxana; Koepke, Melitta; Kalder, Matthias; Hantschmann, Peer; Ratiu, Dominik; Denschlag, Dominik; Schroeder, Willibald; Tuschy, Benjamin; Bau...     »

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.      «

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/...     »