Feasibility of internal inguinoperitoneal drainage after inguinofemoral lymphadenectomy in vulvar cancer

BackgroundLower-limb lymphedema is one of the most disabling adverse effects of vulvar cancer surgery. Multifrequency Bioelectrical Impedance Analysis (MFBIA) is a modern noninvasive method to detect lymphedema. The first aim of this study was to prospectively determine the prevalence of secondary lower-limb lymphedema after surgical treatment for vulvar cancer using objective methods, circumference measurements and MFBIA technique. The second aim was to compare quality of life (QoL) before and 6 months after vulvar surgery.MethodsTwenty-nine patients underwent vulvar cancer surgery in our study: 17 underwent inguinofemoral lymphadenectomy (RAD), and 12 underwent sentinel lymph node biopsy (CONS). Patients were examined before and 6 months after vulvar surgery by measuring the circumference of the lower limbs and with MFBIA. A control group of 27 healthy women was also measured. To evaluate QoL, the European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 months after surgery.ResultsUsing circumference measurement, 9 lymphedemas (31%) were diagnosed: 3 (25%) in the CONS and 6 (37.5%) in the RAD group (P= 0.69). After vulvar surgery, patients in the RAD group reported more fatigue and worsening of physical and role functioning. When comparing both groups, the RAD group had significantly worse parameters in social functioning, fatigue, and dyspnea.ConclusionsLower radicality in inguinofemoral lymphadenectomy shows a trend toward lower morbidity and significantly improves QoL. Multifrequency Bioelectrical Impedance Analysis was tested in these patients as a noninvasive, objective method for lymphedema detection. Detection of lymphedema based on subjective evaluations proved to have an unsatisfactory sensitivity. Less radical surgery showed objectively better results in QoL.

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Faculty Opinions recommendation of Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.740699882.793590521 ◽

2021 ◽

Author(s):

Eva Chalas

Keyword(s):

Sentinel Node ◽

Cancer Patients ◽

Vulvar Cancer ◽

Inguinofemoral Lymphadenectomy

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A Prospective Study in the Evaluation of Quality of Life After Vulvar Cancer Surgery

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000313 ◽

2015 ◽

Vol 25 (1) ◽

pp. 166-173 ◽

Cited By ~ 19

Author(s):

Marta Novackova ◽

Michael J. Halaska ◽

Helena Robova ◽

Ivana Mala ◽

Marek Pluta ◽

...

Keyword(s):

Quality Of Life ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Vulvar Cancer ◽

Lymph Node Biopsy ◽

Cancer Surgery ◽

Node Biopsy ◽

Inguinofemoral Lymphadenectomy

ObjectiveThe aim of this study was to prospectively monitor the patients’ quality of life (QoL) after vulvar cancer surgery.DesignThe design was prospective clinical study.SettingThe study was set in the Department of Obstetrics and Gynecology, 2nd Medical Faculty of the Charles University and University Hospital Motol, Prague, Czech Republic.MethodsA group of 36 patients underwent vulvar cancer surgery: 24 patients were subject to inguinofemoral lymphadenectomy (RAD) and 12 to sentinel lymph node biopsy. To evaluate QoL, the European Organisation for Research and Treatment of Cancer, QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 and 12 months after surgery.ResultsIn patients with vulvar cancer after inguinofemoral lymphadenectomy, increased fatigue and impaired lymphedema were observed. In the group of patients after sentinel lymph node biopsy, none of the QoL variables worsened postoperatively. Comparing both groups 12 months after surgery, the RAD group had significantly worse outcomes in body image and cognitive functioning than the sentinel lymph node biopsy group.Patients in the RAD group, who received adjuvant radiotherapy (n = 13), had worse QoL in symptom experience (P < 0.05) at 6 and 12 months after the surgery than patients without radiotherapy (n = 11).ConclusionsLess radical surgery showed objectively better QoL results.

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Morbidity and quality of life in patients with vulvar cancer after inguinal sentinel lymphadenectomy compared to radical inguinofemoral lymphadenectomy

Nuklearmedizin ◽

10.1055/a-1491-6405 ◽

2021 ◽

Author(s):

Fabinshy Thangarajah ◽

Kristina Rogeé ◽

Caroline Pahmeyer ◽

Kathrin Kuhr ◽

Matthias Schmidt ◽

...

Keyword(s):

Quality Of Life ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Vulvar Cancer ◽

Lymph Node Status ◽

P Value ◽

Sentinel Lymphadenectomy ◽

Significant Difference ◽

Inguinofemoral Lymphadenectomy

Abstract Aim Probability of survival of patients with vulvar cancer directly depends on the lymph node status. Surgery of lymph nodes can be performed as radical inguinofemoral lymphadenectomy or in cases with certain conditions as sentinel lymph node surgery. The aim of this study is to obtain an overview of the intervention-related morbidity and quality of life in patients with vulvar carcinoma after lymphadenectomy. Methods Quality of life and morbidity was compared between patients who underwent radical inguinofemoral lymphadenectomy with those who underwent sentinel lymph node surgery. Results All recorded postoperative complications occur more frequently in the non-sentinel group, Significant difference was shown for the occurrence of lymphedema (p-value = 0.024) and sensitivity loss (p-value = 0.024). Recurrence of disease was more frequent in the non-sentinel group (38 % vs. 20 %, p = 0.621, n.s.) and satisfaction with groin surgery is slightly higher in the sentinel group (94 % vs. 89 %, p = 1.000, n.s.). Conclusion We could demonstrate a significantly lower morbidity of sentinel lymphadenectomy compared to conventional inguinofemoral lymphadenectomy while maintaining the same oncological safety. The low morbidity of sentinel- lymphadenectomy does not seem to influence the postoperative quality of life significantly. However, recording of the individual burden of lymphadenectomy by questionnaires should be optimized.

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Radiotherapy instead of inguinofemoral lymphadenectomy in vulvar cancer patients with a metastatic sentinel node: results of GROINSS-V II

10.1136/ijgc-2019-esgo.16 ◽

2019 ◽

Cited By ~ 1

Author(s):

MHM Oonk ◽

B Slomovitz ◽

P Baldwin ◽

H van Doorn ◽

J van der Velden ◽

...

Keyword(s):

Sentinel Node ◽

Cancer Patients ◽

Vulvar Cancer ◽

Inguinofemoral Lymphadenectomy

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Vulvar melanoma: Rare gynaecological malignancy

10.1055/s-0039-1685378 ◽

2016 ◽

Author(s):

Reena Rani ◽

Asmita Rathore ◽

Latika Sahu ◽

Sangeeta Bhasin

Keyword(s):

Squamous Cell Carcinoma ◽

Postoperative Period ◽

Poor Prognosis ◽

Rare Case ◽

Vulvar Cancer ◽

Rare Type ◽

Gynaecological Malignancy ◽

Radical Vulvectomy ◽

Vulvar Melanoma ◽

Inguinofemoral Lymphadenectomy

Vulvar melanoma is a rare type of gynaecological malignancy. Its poor prognosis and aggressive course provides it more significance than any other vulvar cancer. The knowledge about vulvar melanoma tends to be relatively low as compared to that of squamous cell carcinoma of vulva. This lack of data is due to the infrequency with which vulvar melanoma occurs in any place. In this presentation we are reporting a rare case of vulvar melanoma in a 70 year old lady diagnosed after complaint of persistent vulvar itching discharge per vaginum and a growth on labia on examination. She underwent radical vulvectomy with bilateral inguinofemoral lymphadenectomy and radiotherapy in postoperative period.

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