Optimal therapy of the contralateral groin in individuals with early-stage vulvar squamous cell carcinoma (VSCC) with a metastatic unilateral inguinal sentinel lymph node (SN) is unknown. Researchers investigated patients who participated in GROINSS-V I or II to assess if the therapy of the contralateral groin can safely be neglected in patients with a unilateral metastatic SN. They selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases. They evaluated the incidence of contralateral additional non-SN metastases in individuals with unilateral SN-metastasis who had bilateral inguinofemoral lymphadenectomy (IFL). Those who got only ipsilateral groin treatment or no additional treatment assessed the incidence of contralateral groin recurrences during follow-up. Of 1,912 individuals with early-stage VSCC, 366 developed a unilateral metastatic SN. Subsequently, 244 got an IFL or no treatment of the contralateral groin. In 7 patients(7/244; 2.9% [95% CI: 1.4%-5.8%]), illness was found in the contralateral groin: 5 had contralateral non-SN metastases at IFL, and 2 acquired an isolated contralateral groin recurrence after no further therapy. About 5 of them had a primary tumor more than or equal to 30 mm. Bilateral radiation was delivered in 122 patients, of whom 1 (1/122; 0.8% [95% CI: 0.1%–4.5%]) had a contralateral groin recurrence. Therefore, there is minimal probability of contralateral lymph node metastases in patients with early-stage VSCC and a unilateral metastatic SN. In these instances, it is safe to limit groin treatment to unilateral IFL or inguinofemoral radiation.
Source: sciencedirect.com/science/article/pii/S0090825822004899
