Butler J S B, Milliken D A, Dina R, Eccles S A, Maghami S G, Jameson C, Mason P, Shepherd J H, Soutter W P, Barton D P J
Royal Marsden Hospital, Department of Gynaecological Oncology, London, UK.
Eur J Gynaecol Oncol. 2010;31(5):510-3.
To determine whether there is a node count which can define an adequate inguinofemoral lymphadenectomy (IFL) in primary VSCC.
A retrospective and prospective review of patients with node negative VSCC who had a full staging IFL. Detection of isolated groin recurrences (IGR) would allow groins with higher risk of groin recurrence to be identified.
The median node count of 228 IFLs in 139 patients was eight (0-24). There were six IGR (4.3%). Increased rate of IGR was present in patients with increased age, tumour diameter and depth of invasion, lymphovascular space invasion, unilateral IFL, and moderate/poor tumour grade. In the 138 groins with node counts of eight or greater there were no IGRs compared to six in the patients with either undissected groins or groin node counts less than eight (p = 0.030) Interval to IGR was significantly shorter than other sites of recurrence. Both disease-specific and overall survival were significantly reduced in IGR.
An inadequate IFL is a nodal count of less than eight per groin; both these groins and undissected groins are at increased risk of IGR and should have close surveillance.
确定是否存在一个淋巴结计数可用于界定原发性外阴鳞状细胞癌（VSCC）的充分腹股沟股淋巴结清扫术（IFL）。
对接受完整分期IFL的淋巴结阴性VSCC患者进行回顾性和前瞻性研究。检测孤立性腹股沟复发（IGR）有助于识别腹股沟复发风险较高的腹股沟区。
139例患者的228次IFL清扫的淋巴结计数中位数为8个（0 - 24个）。有6例IGR（4.3%）。年龄增加、肿瘤直径和浸润深度增加、存在淋巴管血管间隙浸润、单侧IFL以及肿瘤分级为中等/差的患者中IGR发生率增加。在淋巴结计数为8个或更多的138个腹股沟区未出现IGR，而在未进行清扫的腹股沟区或淋巴结计数少于8个的患者中有6例出现IGR（p = 0.030）。至IGR的间隔时间明显短于其他复发部位。IGR患者的疾病特异性生存率和总生存率均显著降低。
不充分的IFL是指每个腹股沟区淋巴结计数少于8个；这些腹股沟区以及未进行清扫的腹股沟区发生IGR的风险均增加，应密切监测。
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