Emilie Serre1,2, Emilie Raimond3, Caroline Diguisto1, Sofiane Bendifallah4,5, Gilles Body1,2, Cyril Touboul6, Olivier Graesslin3, Xavier Carcopino7, Emile Daraï4,8, Lobna Ouldamer1,2. 1. Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France. 2. INSERM U1069; Université François-Rabelais, Tours, France. 3. Department of Obstetrics and Gynecology, Institute Alix de Champagne University Hospital, Reims, France. 4. Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Des Hôpitaux de Paris, GRC-6 UPMC, Université Pierre et Marie Curie, France. 5. UMR S 707, Epidemiology, Information Systems, Modeling, Université Pierre et Marie Curie, Paris, France. 6. Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France. 7. Department of Gynecological Surgery, Assistance Publique Des Hôpitaux de Marseille, Marseille, France. 8. Inserm Umr S 938, Université Pierre et Marie Curie, Paris, France.
Abstract
Background and objectives: The aim was to review the clinical impact of groin metastatic nodal disease in women with vulvar squamous cell carcinoma (VSCC) and to evaluate the impact of adjuvant radiotherapy on women with single intracapsular lymph node metastasis (SILNM). Methods: Cohort study of women with vulvar squamous cell carcinoma (VSCC) managed between January 2005 and December 2015 in five institutions in France with prospectively maintained databases (French multicentre tertiary care centres). We evaluated Impact of SILNM on outcome. Results: A total of 176 women (34.6%) had at least one positive lymph node (LN). There were no significant differences for the 5-year overall survival rates between women with one extracapsular LN metastasis and women with one intracapsular LN metastasis, or with two node metastases (p = .62, p = .63 respectively). In women with a SILNM: (1) lymphovascular invasion (LVSI) was an independent negative predictive factor recurrence-free survival (RFS) (HR = 0.10 (95%CI, 0.01-0.90), p = .04) and (2) Adjuvant inguino-femoral radiotherapy was a positive independent factor associated with RFS (HR = 5.87 (95%CI 1.21-28.5), p = .02). Conclusion: A potential positive effect of adjuvant radiotherapy in node positive VSCC, irrespective of the number of affected LN, should be considered especially in the case of LVSI.
Background and objectives: The aim was to review the clinical impact of groin metastatic nodal disease in women with vulvar squamous cell carcinoma (VSCC) and to evaluate the impact of adjuvant radiotherapy on women with single intracapsular lymph node metastasis (SILNM). Methods: Cohort study of women with vulvar squamous cell carcinoma (VSCC) managed between January 2005 and December 2015 in five institutions in France with prospectively maintained databases (French multicentre tertiary care centres). We evaluated Impact of SILNM on outcome. Results: A total of 176 women (34.6%) had at least one positive lymph node (LN). There were no significant differences for the 5-year overall survival rates between women with one extracapsular LN metastasis and women with one intracapsular LN metastasis, or with two node metastases (p = .62, p = .63 respectively). In women with a SILNM: (1) lymphovascular invasion (LVSI) was an independent negative predictive factor recurrence-free survival (RFS) (HR = 0.10 (95%CI, 0.01-0.90), p = .04) and (2) Adjuvant inguino-femoral radiotherapy was a positive independent factor associated with RFS (HR = 5.87 (95%CI 1.21-28.5), p = .02). Conclusion: A potential positive effect of adjuvant radiotherapy in node positive VSCC, irrespective of the number of affected LN, should be considered especially in the case of LVSI.