Risk factors for short- and long-term complications after groin surgery in vulvar cancer
Identifieur interne : 004B72 ( Main/Exploration ); précédent : 004B71; suivant : 004B73Risk factors for short- and long-term complications after groin surgery in vulvar cancer
Auteurs : F. Hinten [Pays-Bas] ; L C G. Van Den Einden [Pays-Bas] ; J C M. Hendriks [Pays-Bas] ; A G J. Van Der Zee [Pays-Bas] ; J. Bulten [Pays-Bas] ; L F A G. Massuger [Pays-Bas] ; H P Van De Nieuwenhof [Pays-Bas] ; J A De Hullu [Pays-Bas]Source :
- British Journal of Cancer [ 0007-0920 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Aine (), Biopsie de noeud lymphatique sentinelle (), Carcinome épidermoïde (), Complications postopératoires (épidémiologie), Diabète (épidémiologie), Drainage, Facteurs de l'âge, Facteurs de risque, Femelle, Humains, Lymphadénectomie (), Procédures de chirurgie gynécologique (), Soins postopératoires, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs de la vulve ().
- MESH :
- épidémiologie : Complications postopératoires, Diabète.
- Adulte, Adulte d'âge moyen, Aine, Biopsie de noeud lymphatique sentinelle, Carcinome épidermoïde, Drainage, Facteurs de l'âge, Facteurs de risque, Femelle, Humains, Lymphadénectomie, Procédures de chirurgie gynécologique, Soins postopératoires, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs de la vulve.
English descriptors
- KwdEn :
- Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Squamous Cell (surgery), Diabetes Mellitus (epidemiology), Drainage, Female, Groin (surgery), Gynecologic Surgical Procedures (methods), Humans, Lymph Node Excision (methods), Middle Aged, Postoperative Care, Postoperative Complications (epidemiology), Risk Factors, Sentinel Lymph Node Biopsy (methods), Vulvar Neoplasms (complications), Vulvar Neoplasms (surgery).
- MESH :
- complications : Vulvar Neoplasms.
- epidemiology : Diabetes Mellitus, Postoperative Complications.
- methods : Gynecologic Surgical Procedures, Lymph Node Excision, Sentinel Lymph Node Biopsy.
- surgery : Carcinoma, Squamous Cell, Groin, Vulvar Neoplasms.
- Adult, Age Factors, Aged, Aged, 80 and over, Drainage, Female, Humans, Middle Aged, Postoperative Care, Risk Factors.
Abstract
The cornerstone of treatment in early-stage squamous cell carcinoma (SCC) of the vulva is surgery, predominantly consisting of wide local excision with elective uni- or bi-lateral inguinofemoral lymphadenectomy. This strategy is associated with a good prognosis, but also with impressive treatment-related morbidity. The aim of this study was to determine risk factors for the short-term (wound breakdown, infection and lymphocele) and long-term (lymphoedema and cellulitis/erysipelas) complications after groin surgery as part of the treatment of vulvar SCC.
Between January 1988 and June 2009, 164 consecutive patients underwent an inguinofemoral lymphadenectomy as part of their surgical treatment for vulvar SCC at the Department of Gynaecologic Oncology at the Radboud University Nijmegen Medical Centre. The clinical and histopathological data were retrospectively analysed.
Multivariate analysis showed that older age, diabetes, ‘en bloc' surgery and higher drain production on the last day of drain
Our analysis shows that patient characteristics, extension of surgery and postoperative management influence short- and/or long-term complications after inguinofemoral lymphadenectomy in vulvar SCC patients. Further research of postoperative management is necessary to analyse possibilities to decrease the complication rate of inguinofemoral lymphadenectomy; although the sentinel lymph node procedure appears to be a promising technique, in ∼50% of the patients an inguinofemoral lymphadenectomy is still indicated.
Url:
DOI: 10.1038/bjc.2011.407
PubMed: 21970884
PubMed Central: 3241565
Affiliations:
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Hinten</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre</institution>, PO Box 9101, 6500 HB Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Den Einden, L C G" sort="Van Den Einden, L C G" uniqKey="Van Den Einden L" first="L C G" last="Van Den Einden">L C G. Van Den Einden</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre</institution>, PO Box 9101, 6500 HB Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hendriks, J C M" sort="Hendriks, J C M" uniqKey="Hendriks J" first="J C M" last="Hendriks">J C M. Hendriks</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Department of Statistics, Radboud University Nijmegen Medical Centre</institution>, Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van Der Zee, A G J" sort="Van Der Zee, A G J" uniqKey="Van Der Zee A" first="A G J" last="Van Der Zee">A G J. Van Der Zee</name><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Department of Obstetrics and Gynaecology, University Medical Centre Groningen</institution>, Groningen,<country>The Netherlands</country>;</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bulten, J" sort="Bulten, J" uniqKey="Bulten J" first="J" last="Bulten">J. Bulten</name><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Pathology, Radboud University Nijmegen Medical Centre</institution>, Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Massuger, L F A G" sort="Massuger, L F A G" uniqKey="Massuger L" first="L F A G" last="Massuger">L F A G. Massuger</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre</institution>, PO Box 9101, 6500 HB Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Van De Nieuwenhof, H P" sort="Van De Nieuwenhof, H P" uniqKey="Van De Nieuwenhof H" first="H P" last="Van De Nieuwenhof">H P Van De Nieuwenhof</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre</institution>, PO Box 9101, 6500 HB Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="De Hullu, J A" sort="De Hullu, J A" uniqKey="De Hullu J" first="J A" last="De Hullu">J A De Hullu</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre</institution>, PO Box 9101, 6500 HB Nijmegen,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">British Journal of Cancer</title><idno type="ISSN">0007-0920</idno><idno type="eISSN">1532-1827</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Carcinoma, Squamous Cell (surgery)</term><term>Diabetes Mellitus (epidemiology)</term><term>Drainage</term><term>Female</term><term>Groin (surgery)</term><term>Gynecologic Surgical Procedures (methods)</term><term>Humans</term><term>Lymph Node Excision (methods)</term><term>Middle Aged</term><term>Postoperative Care</term><term>Postoperative Complications (epidemiology)</term><term>Risk Factors</term><term>Sentinel Lymph Node Biopsy (methods)</term><term>Vulvar Neoplasms (complications)</term><term>Vulvar Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aine ()</term><term>Biopsie de noeud lymphatique sentinelle ()</term><term>Carcinome épidermoïde ()</term><term>Complications postopératoires (épidémiologie)</term><term>Diabète (épidémiologie)</term><term>Drainage</term><term>Facteurs de l'âge</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie ()</term><term>Procédures de chirurgie gynécologique ()</term><term>Soins postopératoires</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs de la vulve ()</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Vulvar Neoplasms</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Diabetes Mellitus</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Gynecologic Surgical Procedures</term><term>Lymph Node Excision</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Groin</term><term>Vulvar Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications postopératoires</term><term>Diabète</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Drainage</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Postoperative Care</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aine</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Carcinome épidermoïde</term><term>Drainage</term><term>Facteurs de l'âge</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Procédures de chirurgie gynécologique</term><term>Soins postopératoires</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Tumeurs de la vulve</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>The cornerstone of treatment in early-stage squamous cell carcinoma (SCC) of the vulva is surgery, predominantly consisting of wide local excision with elective uni- or bi-lateral inguinofemoral lymphadenectomy. This strategy is associated with a good prognosis, but also with impressive treatment-related morbidity. The aim of this study was to determine risk factors for the short-term (wound breakdown, infection and lymphocele) and long-term (lymphoedema and cellulitis/erysipelas) complications after groin surgery as part of the treatment of vulvar SCC.</p></sec><sec><title>Methods:</title><p>Between January 1988 and June 2009, 164 consecutive patients underwent an inguinofemoral lymphadenectomy as part of their surgical treatment for vulvar SCC at the Department of Gynaecologic Oncology at the Radboud University Nijmegen Medical Centre. The clinical and histopathological data were retrospectively analysed.</p></sec><sec><title>Results:</title><p>Multivariate analysis showed that older age, diabetes, ‘en bloc' surgery and higher drain production on the last day of drain <italic>in situ</italic> gave a higher risk of developing short-term complications. Younger age and lymphocele gave higher risk of developing long-term complications. Higher number of lymph nodes dissected seems to protect against developing any long-term complications.</p></sec><sec><title>Conclusion:</title><p>Our analysis shows that patient characteristics, extension of surgery and postoperative management influence short- and/or long-term complications after inguinofemoral lymphadenectomy in vulvar SCC patients. Further research of postoperative management is necessary to analyse possibilities to decrease the complication rate of inguinofemoral lymphadenectomy; although the sentinel lymph node procedure appears to be a promising technique, in ∼50% of the patients an inguinofemoral lymphadenectomy is still indicated.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ansink, Ac" uniqKey="Ansink A">AC Ansink</name></author><author><name sortKey="Sie Go, Dm" uniqKey="Sie Go D">DM Sie-Go</name></author><author><name sortKey="Van Der Velden, J" uniqKey="Van Der Velden J">J van der Velden</name></author><author><name sortKey="Sijmons, Ea" uniqKey="Sijmons E">EA Sijmons</name></author><author><name sortKey="De Barros Lopes, A" uniqKey="De Barros Lopes A">A de Barros Lopes</name></author><author><name sortKey="Monaghan, Jm" uniqKey="Monaghan J">JM Monaghan</name></author><author><name sortKey="Kenter, Gg" uniqKey="Kenter G">GG 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uniqKey="Zhang S">SH Zhang</name></author><author><name sortKey="Sood, Ak" uniqKey="Sood A">AK Sood</name></author><author><name sortKey="Sorosky, Ji" uniqKey="Sorosky J">JI Sorosky</name></author><author><name sortKey="Anderson, B" uniqKey="Anderson B">B Anderson</name></author><author><name sortKey="Buller, Re" uniqKey="Buller R">RE Buller</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Pays-Bas</li></country></list><tree><country name="Pays-Bas"><noRegion><name sortKey="Hinten, F" sort="Hinten, F" uniqKey="Hinten F" first="F" last="Hinten">F. Hinten</name></noRegion><name sortKey="Bulten, J" sort="Bulten, J" uniqKey="Bulten J" first="J" last="Bulten">J. Bulten</name><name sortKey="De Hullu, J A" sort="De Hullu, J A" uniqKey="De Hullu J" first="J A" last="De Hullu">J A De Hullu</name><name sortKey="Hendriks, J C M" sort="Hendriks, J C M" uniqKey="Hendriks J" first="J C M" last="Hendriks">J C M. Hendriks</name><name sortKey="Massuger, L F A G" sort="Massuger, L F A G" uniqKey="Massuger L" first="L F A G" last="Massuger">L F A G. Massuger</name><name sortKey="Van De Nieuwenhof, H P" sort="Van De Nieuwenhof, H P" uniqKey="Van De Nieuwenhof H" first="H P" last="Van De Nieuwenhof">H P Van De Nieuwenhof</name><name sortKey="Van Den Einden, L C G" sort="Van Den Einden, L C G" uniqKey="Van Den Einden L" first="L C G" last="Van Den Einden">L C G. Van Den Einden</name><name sortKey="Van Der Zee, A G J" sort="Van Der Zee, A G J" uniqKey="Van Der Zee A" first="A G J" last="Van Der Zee">A G J. 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