Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival

Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this ris...

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Autores principales:	Neville F. Hacker, Ellen Barlow, Stephen Morrell, Katrina Tang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	inguino-femoral lymphadenectomy lymphedema vulvar cancer medial inguinal nodes lateral inguinal nodes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/0f59a1fcb2ec421a880ffb00ff44c1d1
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spelling	oai:doaj.org-article:0f59a1fcb2ec421a880ffb00ff44c1d12021-11-25T17:04:13ZMedial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival10.3390/cancers132258062072-6694https://doaj.org/article/0f59a1fcb2ec421a880ffb00ff44c1d12021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5806https://doaj.org/toc/2072-6694Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this risk. Methods: We included patients with vulvar cancer of any histological type, even if the cancer extended medially to involve the urethra, anus, or vagina. We excluded patients whose tumor extended (i) laterally onto the thigh, (ii) posteriorly onto the buttocks, or (iii) anteriorly onto the mons pubis. After resection, the inguinal nodes were divided into a medial and a lateral group, based on the lateral border of the femoral artery. Results: Between December 2010 and July 2018, 76 patients underwent some form of groin node dissection, and data were obtained from 112 groins. Approximately one-third of nodes were located lateral to the femoral artery. Positive groin nodes were found in 29 patients (38.2%). All patients with positive nodes had positive nodes medial to the femoral artery. Five patients (6.6%) had positive lateral inguinal nodes. The probability of having a positive lateral node given a negative medial node was estimated to be 0.00002. Conclusion: Provided the medial nodes are negative, medial inguino-femoral lymphadenectomy may suffice and should reduce lower limb lymphedema without compromising survival.Neville F. HackerEllen BarlowStephen MorrellKatrina TangMDPI AGarticleinguino-femoral lymphadenectomylymphedemavulvar cancermedial inguinal nodeslateral inguinal nodesNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5806, p 5806 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	inguino-femoral lymphadenectomy lymphedema vulvar cancer medial inguinal nodes lateral inguinal nodes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	inguino-femoral lymphadenectomy lymphedema vulvar cancer medial inguinal nodes lateral inguinal nodes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Neville F. Hacker Ellen Barlow Stephen Morrell Katrina Tang Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival
description	Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this risk. Methods: We included patients with vulvar cancer of any histological type, even if the cancer extended medially to involve the urethra, anus, or vagina. We excluded patients whose tumor extended (i) laterally onto the thigh, (ii) posteriorly onto the buttocks, or (iii) anteriorly onto the mons pubis. After resection, the inguinal nodes were divided into a medial and a lateral group, based on the lateral border of the femoral artery. Results: Between December 2010 and July 2018, 76 patients underwent some form of groin node dissection, and data were obtained from 112 groins. Approximately one-third of nodes were located lateral to the femoral artery. Positive groin nodes were found in 29 patients (38.2%). All patients with positive nodes had positive nodes medial to the femoral artery. Five patients (6.6%) had positive lateral inguinal nodes. The probability of having a positive lateral node given a negative medial node was estimated to be 0.00002. Conclusion: Provided the medial nodes are negative, medial inguino-femoral lymphadenectomy may suffice and should reduce lower limb lymphedema without compromising survival.
format	article
author	Neville F. Hacker Ellen Barlow Stephen Morrell Katrina Tang
author_facet	Neville F. Hacker Ellen Barlow Stephen Morrell Katrina Tang
author_sort	Neville F. Hacker
title	Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival
title_short	Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival
title_full	Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival
title_fullStr	Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival
title_full_unstemmed	Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival
title_sort	medial inguino-femoral lymphadenectomy for vulvar cancer: an approach to decrease lymphedema without compromising survival
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/0f59a1fcb2ec421a880ffb00ff44c1d1
work_keys_str_mv	AT nevillefhacker medialinguinofemorallymphadenectomyforvulvarcanceranapproachtodecreaselymphedemawithoutcompromisingsurvival AT ellenbarlow medialinguinofemorallymphadenectomyforvulvarcanceranapproachtodecreaselymphedemawithoutcompromisingsurvival AT stephenmorrell medialinguinofemorallymphadenectomyforvulvarcanceranapproachtodecreaselymphedemawithoutcompromisingsurvival AT katrinatang medialinguinofemorallymphadenectomyforvulvarcanceranapproachtodecreaselymphedemawithoutcompromisingsurvival
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Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival

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