Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Early and Late Complications after Inguinofemoral Lymphadenectomy for Vulvar Cancer

  • Cirik, Derya Akdag (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Karalok, Alper (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Ureyen, Isin (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Tasci, Tolga (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Kalyoncu, Rukiye (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Turkmen, Osman (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Kose, M Faruk (Department of Obstetrics and Gynecology, University of Medipol) ;
  • Tulunay, Gokhan (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital) ;
  • Turan, Taner (Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Education and Research Hospital)
  • Published : 2015.08.03
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Abstract

Background: We aimed to determine the frequency of early and late complications following groin surgery for vulvar cancer and analyze possible risk factors. Materials and Methods: This retrospective cohort study included 99 women who underwent for vulvar cancer. The early (${\leq}1$ month) complications were wound infection, breakdown and lymphocyst and late (>1 month) complications were lower limb lymphedema, incontinence and erysipelas. The risk factors for developing each of the complications were analyzed with regression analysis. Results: In the entire cohort, 29 (29.3%) women experienced early and 12 (12.1%) had late complications. Wound complications including infection and breakdown were the leading early complications (23.2%). In the multivariate analysis, both obesity (body mass index ${\geq}30kg/m^2$) and advanced age (${\geq}65years$) were found as independent predictive factors for early complications. Obese women of advanced age had 6.32 times more risk of experiencing any of the early complications, when compared to non-obese and young women (55.6% vs 8.7%). The most common late complication was lower limb lymphedema (10.1%) that was more frequently seen in young women. However, neither age nor lymph node count were significantly associated with the occurrence of lower limb lymphedema. Conclusions: More than 40% of the women suffered from postoperative complications after inguinofemoral lymphadenectomy in the current study. While advanced age and obesity were the significant predictors for any of the early complications, there was no identified risk factor for lower limb lymphedema.

Keywords

References

  1. Angela W, Obermair A (2013). A review of complications associated with the surgical treatment of vulvar cancer. Gynecol Oncol, 131, 467-79. https://doi.org/10.1016/j.ygyno.2013.07.082
  2. De Hullu JA, Oonk MH, van der Zee AG (2004). Modern management of vulvar cancer. Curr Opin Obstet Gynecol, 16, 65-72. https://doi.org/10.1097/00001703-200402000-00012
  3. Gaarenstroom KN, Kenter GG, Trimbos JB, et al (2003). Postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using seperate groin incisions. Int J Gynecol Cancer, 13, 522-7. https://doi.org/10.1046/j.1525-1438.2003.13304.x
  4. Goker A, Guvenal T, Yanikkerem E, Turhan A, Koyuncu FM (2011). Quality of life in women with gynecologic cancer in Turkey. Asian Pac J Cancer Prev, 12, 3121-8.
  5. Gould N, Kamelle S, Tillmanns T, et al (2001). Predictors of complications after inguinal lymphadenectomy. Gynecologic Oncology, 82, 329-32. https://doi.org/10.1006/gyno.2001.6266
  6. Greene AK, Grant FD, Slavin SA (2012). Lower-extremity lymphedema and elevated body-mass index. N Engl J Med, 366, 2136-7.
  7. Hacker NF, Berek JS, Lagessa LD, Leuchter RS, Moore JG (1983). Management of regional lymph nodes and their prognostic influence in vulvar cancer. Obstet Gynecol, 61, 408-12.
  8. Hinten F, van den Einden LC, Hendriks JC, et al (2011). Risk factors for short-and long-term complications after groin surgery in vulvar cancer. Br J Cancer, 105, 1279-87. https://doi.org/10.1038/bjc.2011.407
  9. Janda M, Obermair A, Cella D, Crandon AJ, Trimmel M (2004). Vulvar cancer patients' quality of life: a qualitative assessment. Int J Gynecol Cancer, 14, 875-81. https://doi.org/10.1111/j.1048-891X.2004.14524.x
  10. Jensen MR, Simonsen L, Karlsmark T, Bulow J (2010). Lymphedema of the lower extremities-background, pathophysiology and diagnostic considerations. Clin Physiol Funct Imaging, 30, 389-98. https://doi.org/10.1111/j.1475-097X.2010.00969.x
  11. Levenback C, Morris M, Burke TW, Gershenson DM, Wolf JK, Wharton JT (1996). Groin dissection practices among gynecologic oncologists treating early vulvar cancer. Gynecol Oncol, 62, 73-7. https://doi.org/10.1006/gyno.1996.0192
  12. Oonk MH, van Hemel BM, Hollema H, et al (2010). Size of sentinel-node metastasis and chances of non-sentinel-node involvement and survival in early stage vulvar cancer: results from GROINSS-V, a multicentre observational study. Lancet Oncol, 11, 646-52. https://doi.org/10.1016/S1470-2045(10)70104-2
  13. Podratz KC, Symmonds RE, Taylor WF, Williams TJ (1983). Carcinoma of the vulva:analysis of treatment and survival. Obstet Gynecol, 61, 63-74.
  14. Qiang Wu, Zhao YB, Sun ZH, et al (2013). Clinical application of endoscopic inguinal lymph node resection after lipolysis and liposuction for vulvar cancer. Asian Pac J Cancer Prev, 14, 7121-6. https://doi.org/10.7314/APJCP.2013.14.12.7121
  15. Shack L, Lau HY, Huang L, Doll C, Hao D (2014). Trends in the incidence of human papillomavirus-related noncervical and cervical cancers in Alberta, Canada: a population-based study. CMAJ Open, 2, 127-32. https://doi.org/10.9778/cmajo.20140005
  16. Siegel R, Ma J, Zou Z, Jemal A (2014). Cancer statistics, CA: Cancer J Clin, 64, 9-29. https://doi.org/10.3322/caac.21208
  17. Soliman AA, Heubner M, Kimmig R, Wimberger P (2012). Morbidity of inguinofemoral lymphadenectomy in vulval cancer. Scientific World J, [Epub ahead of print-2012].
  18. Van der Zee AG, Oonk MH, De Hullu JA, et al (2008). Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol, 26, 884-9. https://doi.org/10.1200/JCO.2007.14.0566
  19. Walker KF, Day H, Abu J, Nunns D, Williamson K, Duncan T (2011). Do surgical techniques used in groin lymphadenectomy for vulval cancer affect morbidity rates? Int J Gynecol Cancer, 21, 1495-9. https://doi.org/10.1097/IGC.0b013e318228f314
  20. Yost KJ, Cheville AL, Al-Hilli MM, et al (2014). Lymphedema after surgery for endometrial cancer: prevalence, risk factors, and quality of life. Obstet Gynecol, 124, 307-15. https://doi.org/10.1097/AOG.0000000000000372

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