Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study

Noortje Pleunis; Anne Floor W. Pouwer; Maaike H.M. Oonk; Helena C. van Doorn; Ming Y. Tjiong; Jacobus van der Velden; Henry Zijlmans; Mariette I.E. van Poelgeest; Eleonora B. van Dorst; Brigitte F.M. Slangen; Lia C.G. Verhoef; Johanna M.A. Pijnenborg; Joanne A. de Hullu

doi:10.1038/s41416-023-02373-0

Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study

Noortje Pleunis^*
, Anne Floor W. Pouwer
, Maaike H.M. Oonk
, Helena C. van Doorn
, Ming Y. Tjiong
, Jacobus van der Velden
, Henry Zijlmans
, Mariette I.E. van Poelgeest
, Eleonora B. van Dorst
, Brigitte F.M. Slangen
, Lia C.G. Verhoef
, Johanna M.A. Pijnenborg
, Joanne A. de Hullu

^*Corresponding author for this work

Gynecological Oncology

Radboud University Medical Center
Rijnstate Hospital
University Medical Centre Groningen
Amsterdam UMC
Antoni van Leeuwenhoek Hospital
Leiden University Medical Centre
Utrecht University
Maastricht University
Radboud University Nijmegen

Research output: Contribution to journal › Article › Academic › peer-review

2 Citations (Scopus)

Abstract

Background:

Up to 40% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors.

Methods:

A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N−) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed.

Results:

Overall, 16.3% (66/404) had a N+ groin status at first local recurrence, 66.4% (268/404) N− and 17.3% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5% and 13.8%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9%; P = 0.050) at local recurrence.

Conclusions:

The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.

Original language	English
Pages (from-to)	956-964
Number of pages	9
Journal	British Journal of Cancer
Volume	129
Issue number	6
DOIs	https://doi.org/10.1038/s41416-023-02373-0
Publication status	Published - 5 Oct 2023

Bibliographical note

Funding Information:
Published conference abstracts: in an earlier stage of the study, the abstract was presented at the European Society of Gynecological Oncology (ESGO) meeting in 2019 [30]. Additional contributions: Martijn Mensink, Anouk van Heertum and Anne Hompesch are medical (Master of Science) students and were involved in the data collection process as part of their thesis.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Limited.

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SDG 3 Good Health and Well-being

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10.1038/s41416-023-02373-0

https://research.rug.nl/en/publications/incidence-of-inguinofemoral-lymph-node-metastases-at-the-first-loLicence: Article 25fa Dutch Copyright Act

Cite this

Pleunis, N., Pouwer, A. F. W., Oonk, M. H. M., van Doorn, H. C., Tjiong, M. Y., van der Velden, J., Zijlmans, H., van Poelgeest, M. I. E., van Dorst, E. B., Slangen, B. F. M., Verhoef, L. C. G., Pijnenborg, J. M. A., & de Hullu, J. A. (2023). Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study. British Journal of Cancer, 129(6), 956-964. https://doi.org/10.1038/s41416-023-02373-0

@article{383eaa557fa941f8b651f50ee7474007,

title = "Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study",

abstract = "Background:Up to 40\% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors. Methods: A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N−) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed. Results: Overall, 16.3\% (66/404) had a N+ groin status at first local recurrence, 66.4\% (268/404) N− and 17.3\% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5\% and 13.8\%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9\%; P = 0.050) at local recurrence. Conclusions: The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3\%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.",

author = "Noortje Pleunis and Pouwer, \{Anne Floor W.\} and Oonk, \{Maaike H.M.\} and \{van Doorn\}, \{Helena C.\} and Tjiong, \{Ming Y.\} and \{van der Velden\}, Jacobus and Henry Zijlmans and \{van Poelgeest\}, \{Mariette I.E.\} and \{van Dorst\}, \{Eleonora B.\} and Slangen, \{Brigitte F.M.\} and Verhoef, \{Lia C.G.\} and Pijnenborg, \{Johanna M.A.\} and \{de Hullu\}, \{Joanne A.\}",

note = "Funding Information: Published conference abstracts: in an earlier stage of the study, the abstract was presented at the European Society of Gynecological Oncology (ESGO) meeting in 2019 [30]. Additional contributions: Martijn Mensink, Anouk van Heertum and Anne Hompesch are medical (Master of Science) students and were involved in the data collection process as part of their thesis. Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Nature Limited.",

year = "2023",

month = oct,

day = "5",

doi = "10.1038/s41416-023-02373-0",

language = "English",

volume = "129",

pages = "956--964",

journal = "British Journal of Cancer",

issn = "0007-0920",

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Pleunis, N, Pouwer, AFW, Oonk, MHM, van Doorn, HC, Tjiong, MY, van der Velden, J, Zijlmans, H, van Poelgeest, MIE, van Dorst, EB, Slangen, BFM, Verhoef, LCG, Pijnenborg, JMA & de Hullu, JA 2023, 'Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study', British Journal of Cancer, vol. 129, no. 6, pp. 956-964. https://doi.org/10.1038/s41416-023-02373-0

TY - JOUR

T1 - Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer

T2 - a Dutch nationwide study

AU - Pleunis, Noortje

AU - Pouwer, Anne Floor W.

AU - Oonk, Maaike H.M.

AU - van Doorn, Helena C.

AU - Tjiong, Ming Y.

AU - van der Velden, Jacobus

AU - Zijlmans, Henry

AU - van Poelgeest, Mariette I.E.

AU - van Dorst, Eleonora B.

AU - Slangen, Brigitte F.M.

AU - Verhoef, Lia C.G.

AU - Pijnenborg, Johanna M.A.

AU - de Hullu, Joanne A.

N1 - Funding Information: Published conference abstracts: in an earlier stage of the study, the abstract was presented at the European Society of Gynecological Oncology (ESGO) meeting in 2019 [30]. Additional contributions: Martijn Mensink, Anouk van Heertum and Anne Hompesch are medical (Master of Science) students and were involved in the data collection process as part of their thesis. Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2023/10/5

Y1 - 2023/10/5

N2 - Background:Up to 40% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors. Methods: A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N−) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed. Results: Overall, 16.3% (66/404) had a N+ groin status at first local recurrence, 66.4% (268/404) N− and 17.3% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5% and 13.8%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9%; P = 0.050) at local recurrence. Conclusions: The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.

AB - Background:Up to 40% of vulvar cancer patients present with local recurrence within 10 years of follow-up. An inguinofemoral lymphadenectomy (IFL) is indicated if not performed at primary treatment. The incidence and risk factors for lymph node metastases (LNM) at first local recurrence, however, are unclear. Our aim was to determine the incidence of LNM at first local recurrence, in relation to previous groin treatment and clinicopathological factors. Methods: A multicenter cohort study including vulvar cancer patients with a first macroinvasive local recurrence after primary surgical treatment between 2000 and 2015 was conducted in the Netherlands. Groin status at local recurrence was defined as positive (N+), negative (N−) or unknown (N?) and based on histology, imaging and follow-up. Patient-, tumour- and treatment characteristics of primary and recurrent disease were analysed. Results: Overall, 16.3% (66/404) had a N+ groin status at first local recurrence, 66.4% (268/404) N− and 17.3% (70/404) N? groin status. The incidence of a N+ groin status was comparable after previous SLN and IFL, 11.5% and 13.8%, respectively. A N+ groin status was related to tumour size (25 vs.12 mm; P < 0.001), depth of invasion (5 vs. 3 mm; P < 0.001) and poorly differentiated tumours (22.9 vs. 11.9%; P = 0.050) at local recurrence. Conclusions: The incidence of LNM at first local recurrence in vulvar cancer patients was 16.3%, and independent of previous type of groin surgery. In accordance with primary diagnosis, tumour size, depth of invasion, and tumour grade were significantly associated with a positive groin status.

UR - https://www.scopus.com/pages/publications/85170254555

U2 - 10.1038/s41416-023-02373-0

DO - 10.1038/s41416-023-02373-0

M3 - Article

C2 - 37507545

AN - SCOPUS:85170254555

SN - 0007-0920

VL - 129

SP - 956

EP - 964

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 6

ER -

Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study

Abstract

Bibliographical note

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