title: Prognostic value of lymph node status and number of removed nodes in patients with squamous cell carcinoma of the vulva treated with modified radical vulvectomy and inguinal-femoral lymphadenectomy.
abstract: OBJECTIVE
  To assess the outcome of patients with squamous cell vulvar carcinoma treated with deep partial or total vulvectomy and inguinal-femoral lymphadenectomy.
  
  
  METHODS
  The authors assessed 87 patients who underwent primary surgery.
  
  
  RESULTS
  Tumor recurred in 34 patients, and the first relapse was local in 19, inguinal in ten, and distant in five. Five-year disease-free survival was 56.7% and was related to Stage (p < 0.0001), grade (p = 0.023), and node status (p < 0.0001). Groin failure occurred in 4.9% of node-negative patients compared with 29.6% of node-positive patients (p = 0.0096). Distant recurrences only developed in women with positive nodes. Among the 47 patients who underwent bilateral lymphadenectomy and who had negative nodes, groin recurrence occurred in 12% of those who had < or = 15 nodes removed and 0% of those who had > 15 nodes removed.
  
  
  CONCLUSIONS
  Stage and node status were the most important prognostic variables. There was a trend favoring a better groin control in patients with node-negative disease who underwent extensive lymphadenectomy.
authors: Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy. a.gadducci@obgyn.med.unipi.it
authors: A
authors: A
authors: Gadducci
authors: A
authors: A
authors: Ferrero
authors: R
authors: R
authors: Tana
authors: M G
authors: MG
authors: Fabrini
authors: P
authors: P
authors: Modaffari
authors: A
authors: A
authors: Fanucchi
authors: C
authors: C
authors: Vignati
authors: P
authors: P
authors: Zola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D014844:Vulva / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*