title: Node count and groin recurrence in early vulvar cancer: A Gynecologic Oncology Group study.
abstract: OBJECTIVE
  To determine if low node count from superficial groin dissection correlated with first recurrence in the groin for patients with early vulvar cancer.
  
  
  METHODS
  The Gynecologic Oncology Group (GOG) conducted a trial for patients with early stage squamous vulvar cancer, lesions <2 cm in size and <5 mm in depth. All fatty tissue below the inguinal ligament, medial to the sartorious and lateral to the adductor longus was removed. Incision of the fascia and skeletonizing the femoral vessels were not required. For this secondary analysis, we reviewed the records of all patients to assess node counts.
  
  
  RESULTS
  Of the 113 patients eligible for the study, 104 patients (with 117 dissected groins) did not have a first recurrence in the groin. The median number of negative nodes was 9 (range: 1-26). Nine patients (with 9 dissected groins) suffered a first recurrence in the groin. The median number of negative nodes removed per groin was 7 (range: 4-22). There were no significant differences between patients with first recurrence in the groin and those without (p value=0.7475). There was a broad overlap of the confidence intervals.
  
  
  CONCLUSIONS
  We were unable to show that groin failure after superficial lymphadenectomy was a result of low lymph node count. The small number of recurrences made firm conclusions impossible. Variations in anatomy and other factors may make node counting an unreliable measure of surgical quality.
authors.affiliation: Gynecologic Oncology, The Clarence E. Ehrlich Chair Emeritus, Department of Obstetrics and Gynecology, Indiana University School of Medicine, 535 Barnhill, #433, Indianapolis, IN 46202, USA. FStehman@iupui.edu
authors.forename: Frederick B
authors.initials: FB
authors.lastname: Stehman
authors.forename: Shamshad
authors.initials: S
authors.lastname: Ali
authors.forename: Philip J
authors.initials: PJ
authors.lastname: DiSaia
mesh_terms: D005260:Female; D006801:Humans; D007264:Inguinal Canal / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012307:Risk Factors; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery