title: Sentinel nodes in vulvar cancer: Long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I.
abstract: OBJECTIVE
  In 2008 GROINSS-V-I, the largest validation trial on the sentinel node (SN) procedure in vulvar cancer, showed that application of the SN-procedure in patients with early-stage vulvar cancer is safe. The current study aimed to evaluate long-term follow-up of these patients regarding recurrences and survival.
  
  
  METHODS
  From 2000 until 2006 GROINSS-V-I included 377 patients with unifocal squamous cell carcinoma of the vulva (T1, <4 cm), who underwent the SN-procedure. Only in case of SN metastases an inguinofemoral lymphadenectomy was performed. For the present study follow-up was completed until March 2015.
  
  
  RESULTS
  Themedian follow-up was 105 months (range 0–179). The overall local recurrence ratewas 27.2% at 5 years and 39.5% at 10 years after primary treatment, while for SN-negative patients 24.6% and 36.4%, and for SN-positive patients 33.2% and 46.4% respectively (p = 0.03). In 39/253 SN-negative patients (15.4%) an inguinofemoral lymphadenectomy was performed, because of a local recurrence. Isolated groin recurrence rate was 2.5% for SN-negative patients and 8.0% for SN-positive patients at 5 years. Disease-specific 10-year survival was 91% for SN-negative patients compared to 65% for SN-positive patients (p b .0001). For all patients, 10-year disease-specific survival decreased from 90% for patients without to 69% for patients with a local recurrence (p b .0001).
authors.affiliation: Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
authors.forename: N C
authors.initials: NC
authors.lastname: Te Grootenhuis
authors.affiliation: Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
authors.forename: A G J
authors.initials: AG
authors.lastname: van der Zee
authors.affiliation: Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: van Doorn
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: van der Velden
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Vergote
authors.affiliation: Department of Obstetrics and Gynaecology, European Cancer Institute, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Zanagnolo
authors.affiliation: Department of Gynaecological Oncology, Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: P J
authors.initials: PJ
authors.lastname: Baldwin
authors.affiliation: Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, Netherlands.
authors.forename: K N
authors.initials: KN
authors.lastname: Gaarenstroom
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: E B
authors.initials: EB
authors.lastname: van Dorst
authors.affiliation: Department of Obstetrics and Gynaecology, VU Medical Center, Amsterdam, Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Trum
authors.affiliation: Department of Obstetrics and Gynaecology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: B F M
authors.initials: BF
authors.lastname: Slangen
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Jena, Jena, Germany.
authors.forename: I B
authors.initials: IB
authors.lastname: Runnebaum
authors.affiliation: Department of Obstetrics and Gynaecology, Medical University Graz, Graz, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Tamussino
authors.affiliation: Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, Netherlands.
authors.forename: R H
authors.initials: RH
authors.lastname: Hermans
authors.affiliation: Department of Obstetrics and Gynaecology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
authors.forename: D M
authors.initials: DM
authors.lastname: Provencher
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
authors.forename: G H
authors.initials: GH
authors.lastname: de Bock
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: de Hullu
authors.affiliation: Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. Electronic address: m.h.m.oonk@umcg.nl.
authors.forename: M H M
authors.initials: MH
authors.lastname: Oonk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods* / Q000592:standards; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000473:pathology*
keywords: Long-term follow-up; Sentinel node; Vulvar cancer