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Nuklearmedizin 2021; 60(05): 368-374
DOI: 10.1055/a-1491-6405
Original Article

Morbidity and quality of life in patients with vulvar cancer after inguinal sentinel lymphadenectomy compared to radical inguinofemoral lymphadenectomy

Morbidität und Lebensqualität von Patientinnen mit Vulvakarzinom nach inguinaler Sentinel-Lymphadenektomie im Vergleich zur radikalen inguinofemoralen Lymphadenektomie
Fabinshy Thangarajah
1   Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany
,
Kristina Rogeé
2   Department of Gynecology and Obstetrics, GFO Clinic Rhein-Berg; Vinzenz-Pallotti-Hospital, Bergisch Gladbach-Bensberg, Germany
,
Caroline Pahmeyer
1   Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany
,
Kathrin Kuhr
3   Institute of Medical Statistics and Computational Biology, University of Cologne, Germany
,
Matthias Schmidt
4   Department of Nuclear Medicine, University of Cologne, Germany
,
Claudius Fridrich
5   Department of Gynecology and Obstetrics, Heilig-Geist-Krankenhaus, Cologne, Germany
,
Bernd Morgenstern
1   Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany
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Abstract

Aim Probability of survival of patients with vulvar cancer directly depends on the lymph node status. Surgery of lymph nodes can be performed as radical inguinofemoral lymphadenectomy or in cases with certain conditions as sentinel lymph node surgery. The aim of this study is to obtain an overview of the intervention-related morbidity and quality of life in patients with vulvar carcinoma after lymphadenectomy.

Methods Quality of life and morbidity was compared between patients who underwent radical inguinofemoral lymphadenectomy with those who underwent sentinel lymph node surgery.

Results All recorded postoperative complications occur more frequently in the non-sentinel group, Significant difference was shown for the occurrence of lymphedema (p-value = 0.024) and sensitivity loss (p-value = 0.024). Recurrence of disease was more frequent in the non-sentinel group (38 % vs. 20 %, p = 0.621, n.s.) and satisfaction with groin surgery is slightly higher in the sentinel group (94 % vs. 89 %, p = 1.000, n.s.).

Conclusion We could demonstrate a significantly lower morbidity of sentinel lymphadenectomy compared to conventional inguinofemoral lymphadenectomy while maintaining the same oncological safety. The low morbidity of sentinel- lymphadenectomy does not seem to influence the postoperative quality of life significantly. However, recording of the individual burden of lymphadenectomy by questionnaires should be optimized.

Zusammenfassung

Ziel Die Überlebenswahrscheinlichkeit von Patientinnen mit Vulvakarzinom hängt direkt vom Lymphknotenstatus ab. Die Resektion der Lymphknoten kann als radikale inguinofemorale Lymphadenektomie oder bei Vorliegen bestimmter Voraussetzungen als Sentinel-Lymphadenektomie durchgeführt werden. Ziel dieser Studie ist es, einen Überblick über die interventionelle Morbidität und Lebensqualität bei Patientinnen mit Vulvakarzinom nach Lymphadenektomie zu erhalten.

Methoden Lebensqualität und Morbidität wurden zwischen Patientinnen, bei denen eine radikale inguinofemorale Lymphadenektomie durchgeführt wurde, und Patientinnen, bei denen eine Sentinel-Lymphknotenchirurgie durchgeführt wurde, verglichen.

Ergebnisse Alle erfassten postoperativen Komplikationen traten in der Nicht-Sentinel-Gruppe häufiger auf, ein signifikanter Unterschied zeigte sich für das Auftreten von Lymphödemen (p = 0,024) und Sensibilitätsverlust (p = 0,024). Krankheitsrezidive traten in der Nicht-Sentinel-Gruppe häufiger auf (38 % vs. 20 %; p = 0,621, n.s.) und die Zufriedenheit mit dem Eingriff in der Leistenregion war in der Sentinel-Gruppe etwas höher (94 % vs. 89 %; p = 1,000, n.s.).

Schlussfolgerung Wir konnten eine signifikant geringere Morbidität der Sentinel-Lymphadenektomie im Vergleich zur konventionellen inguinofemoralen Lymphadenektomie bei gleichbleibender onkologischer Sicherheit nachweisen. Die niedrigere Morbidität bei der Sentinel-Lymphadenektomie hat keinen signifikanten Einfluss auf die postoperative Lebensqualität. Die Erfassung der individuellen Belastung durch die Lymphadenektomie mittels Fragebögen sollte jedoch optimiert werden.

Key words

vulva carcinoma - lymph node surgery - sentinel - quality of life

Schlüsselwörter

Vulvakarzinom - Lymphknotenchirurgie - Sentinel - Lebensqualität


Publication History

Received: 18 January 2021

Accepted: 21 April 2021

Article published online:
24 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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