Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II
Maaike HM Oonk
1
,
Brian M Slomovitz
2
,
Peter J W Baldwin
3
,
Helena C. van Doorn
4
,
Jacobus Van Der Velden
5
,
Joanne A de Hullu
6
,
Katja N. Gaarenstroom
7
,
Brigitte Slangen
8
,
Ignace B. Vergote
9
,
Mats Brännström
10
,
Eleonora B L Van Dorst
11
,
Willemien J. van Driel
12
,
Ralph H. Hermans
13
,
David Nunns
14
,
Martin Widschwendter
15
,
David Nugent
16
,
Cathrine M. Holland
17
,
Aarti Sharma
18
,
Paul Disilvestro
19
,
Robert Mannel
20
,
Dorry Boll
13
,
David Cibula
21
,
Al Covens
22
,
Diane Provencher
23
,
Ingo B. Runnebaum
24
,
David Luesley
25
,
Patricia Ellis
26
,
Timothy J Duncan
27
,
Ming Y. Tjiong
5
,
Derek J. Cruickshank
28
,
P. Kjølhede
29
,
Charles F. Levenback
30
,
Jiri Bouda
31
,
Katharina E. Kieser
32
,
Connie Palle
33
,
Nicola M. Spirtos
34
,
David M. O’Malley
35
,
Mario Leitao
36
,
Melissa A Geller
37
,
Kalyan Dhar
38
,
Viren Asher
39
,
KARL TAMUSSINO
40
,
Daniel H. Tobias
41
,
Christer Borgfeldt
42
,
Jayanthi S Lea
43
,
Jo Bailey
44
,
Margareta Lood
45
,
Brynhildur Eyjólfsdóttir
46
,
Stephen Attard Montalto
47
,
Krishnansu S. Tewari
48
,
Ranjit Manchanda
49
,
Pernille T. Jensen
50
,
Par Persson
51
,
Linda Van Le
52
,
Hein Putter
7
,
Geertruida H. de Bock
1
,
Bradley J. Monk
53
,
Ate G. J. van der Zee
1
2
Mount Sinai Medical Center, Miami Beach, FL
|
16
Leeds Teaching Hospitals NHS Trust, St James' University Hospital, Leeds, United Kingdom
|
18
University Hospital of Wales, Cardiff, United Kingdom
|
19
Women and Infants Hospital of Rhode Island, Providence, RI
|
26
Royal Surrey NHS foundation trust, Guildford, United Kingdom
|
27
Norfolk and Norwich University hospital NHS trust, Norwich, United Kingdom
|
28
James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United Kingdom
|
33
Capio, Part of Ramsey Santé, Hellerup, Denmark
|
34
Women's Cancer Center of Nevada, Las Vegas, NV
|
38
Singleton Hospital, Swansea, United Kingdom
|
39
University Hospitals of Derby and Burton, Derby, United Kingdom
|
41
Morristown Medical Center, Morristown, NJ
|
44
St Michaels Hospital, Bristol, United Kingdom
|
47
West Kent Cancer Centre, Maidstone Hospital, Maidstone, United Kingdom
|
49
53
St Josephs Hospital and Medical Center, Phoenix, AZ
|
Publication type: Journal Article
Publication date: 2021-11-10
scimago Q1
wos Q1
SJR: 11.205
CiteScore: 38.9
Impact factor: 41.9
ISSN: 0732183X, 15277755
PubMed ID:
34432481
Cancer Research
Oncology
Abstract
PURPOSE
The Groningen International Study on Sentinel nodes in Vulvar cancer (GROINSS-V)-II investigated whether inguinofemoral radiotherapy is a safe alternative to inguinofemoral lymphadenectomy (IFL) in vulvar cancer patients with a metastatic sentinel node (SN).
METHODS
GROINSS-V-II was a prospective multicenter phase-II single-arm treatment trial, including patients with early-stage vulvar cancer (diameter < 4 cm) without signs of lymph node involvement at imaging, who had primary surgical treatment (local excision with SN biopsy). Where the SN was involved (metastasis of any size), inguinofemoral radiotherapy was given (50 Gy). The primary end point was isolated groin recurrence rate at 24 months. Stopping rules were defined for the occurrence of groin recurrences.
RESULTS
From December 2005 until October 2016, 1,535 eligible patients were registered. The SN showed metastasis in 322 (21.0%) patients. In June 2010, with 91 SN-positive patients included, the stopping rule was activated because the isolated groin recurrence rate in this group went above our predefined threshold. Among 10 patients with an isolated groin recurrence, nine had SN metastases > 2 mm and/or extracapsular spread. The protocol was amended so that those with SN macrometastases (> 2 mm) underwent standard of care (IFL), whereas patients with SN micrometastases (≤ 2 mm) continued to receive inguinofemoral radiotherapy. Among 160 patients with SN micrometastases, 126 received inguinofemoral radiotherapy, with an ipsilateral isolated groin recurrence rate at 2 years of 1.6%. Among 162 patients with SN macrometastases, the isolated groin recurrence rate at 2 years was 22% in those who underwent radiotherapy, and 6.9% in those who underwent IFL ( P = .011). Treatment-related morbidity after radiotherapy was less frequent compared with IFL.
CONCLUSION
Inguinofemoral radiotherapy is a safe alternative for IFL in patients with SN micrometastases, with minimal morbidity. For patients with SN macrometastasis, radiotherapy with a total dose of 50 Gy resulted in more isolated groin recurrences compared with IFL.
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Metrics
110
Total citations:
110
Citations from 2024:
46
(41.81%)
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MLA
Cite this
GOST
Copy
Oonk M. H. et al. Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II // Journal of Clinical Oncology. 2021. Vol. 39. No. 32. pp. 3623-3632.
GOST all authors (up to 50)
Copy
Oonk M. H. et al. Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II // Journal of Clinical Oncology. 2021. Vol. 39. No. 32. pp. 3623-3632.
Cite this
RIS
Copy
TY - JOUR
DO - 10.1200/jco.21.00006
UR - https://doi.org/10.1200/jco.21.00006
TI - Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II
T2 - Journal of Clinical Oncology
AU - Oonk, Maaike HM
AU - Slomovitz, Brian M
AU - Baldwin, Peter J W
AU - van Doorn, Helena C.
AU - Van Der Velden, Jacobus
AU - de Hullu, Joanne A
AU - Gaarenstroom, Katja N.
AU - Slangen, Brigitte
AU - Vergote, Ignace B.
AU - Brännström, Mats
AU - Van Dorst, Eleonora B L
AU - van Driel, Willemien J.
AU - Hermans, Ralph H.
AU - Nunns, David
AU - Widschwendter, Martin
AU - Nugent, David
AU - Holland, Cathrine M.
AU - Sharma, Aarti
AU - Disilvestro, Paul
AU - Mannel, Robert
AU - Boll, Dorry
AU - Cibula, David
AU - Covens, Al
AU - Provencher, Diane
AU - Runnebaum, Ingo B.
AU - Luesley, David
AU - Ellis, Patricia
AU - Duncan, Timothy J
AU - Tjiong, Ming Y.
AU - Cruickshank, Derek J.
AU - Kjølhede, P.
AU - Levenback, Charles F.
AU - Bouda, Jiri
AU - Kieser, Katharina E.
AU - Palle, Connie
AU - Spirtos, Nicola M.
AU - O’Malley, David M.
AU - Leitao, Mario
AU - Geller, Melissa A
AU - Dhar, Kalyan
AU - Asher, Viren
AU - TAMUSSINO, KARL
AU - Tobias, Daniel H.
AU - Borgfeldt, Christer
AU - Lea, Jayanthi S
AU - Bailey, Jo
AU - Lood, Margareta
AU - Eyjólfsdóttir, Brynhildur
AU - Attard Montalto, Stephen
AU - Tewari, Krishnansu S.
AU - Manchanda, Ranjit
AU - Jensen, Pernille T.
AU - Persson, Par
AU - Van Le, Linda
AU - Putter, Hein
AU - de Bock, Geertruida H.
AU - Monk, Bradley J.
AU - Creutzberg, Carien L.
AU - van der Zee, Ate G. J.
PY - 2021
DA - 2021/11/10
PB - American Society of Clinical Oncology (ASCO)
SP - 3623-3632
IS - 32
VL - 39
PMID - 34432481
SN - 0732-183X
SN - 1527-7755
ER -
Cite this
BibTex (up to 50 authors)
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@article{2021_Oonk,
author = {Maaike HM Oonk and Brian M Slomovitz and Peter J W Baldwin and Helena C. van Doorn and Jacobus Van Der Velden and Joanne A de Hullu and Katja N. Gaarenstroom and Brigitte Slangen and Ignace B. Vergote and Mats Brännström and Eleonora B L Van Dorst and Willemien J. van Driel and Ralph H. Hermans and David Nunns and Martin Widschwendter and David Nugent and Cathrine M. Holland and Aarti Sharma and Paul Disilvestro and Robert Mannel and Dorry Boll and David Cibula and Al Covens and Diane Provencher and Ingo B. Runnebaum and David Luesley and Patricia Ellis and Timothy J Duncan and Ming Y. Tjiong and Derek J. Cruickshank and P. Kjølhede and Charles F. Levenback and Jiri Bouda and Katharina E. Kieser and Connie Palle and Nicola M. Spirtos and David M. O’Malley and Mario Leitao and Melissa A Geller and Kalyan Dhar and Viren Asher and KARL TAMUSSINO and Daniel H. Tobias and Christer Borgfeldt and Jayanthi S Lea and Jo Bailey and Margareta Lood and Brynhildur Eyjólfsdóttir and Stephen Attard Montalto and Krishnansu S. Tewari and others},
title = {Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II},
journal = {Journal of Clinical Oncology},
year = {2021},
volume = {39},
publisher = {American Society of Clinical Oncology (ASCO)},
month = {nov},
url = {https://doi.org/10.1200/jco.21.00006},
number = {32},
pages = {3623--3632},
doi = {10.1200/jco.21.00006}
}
Cite this
MLA
Copy
Oonk, Maaike HM, et al. “Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II.” Journal of Clinical Oncology, vol. 39, no. 32, Nov. 2021, pp. 3623-3632. https://doi.org/10.1200/jco.21.00006.