In patients with vulvar or labia cancer, the tumor is removed as standard. The so-called sentinel node procedure is performed for tumors smaller than 4 centimeters: an operation in which not all lymph nodes, but only the first lymph node stations are removed from the groin or groin.
When the sentinel node contains a metastasis, all lymph nodes from the groin or groin are removed during a second operation. This procedure is associated with many side effects in both the short and long term, such as wound healing problems, infections and the development of lymphedema of the legs.
59 hospitals in 11 countries
Ate van der Zee, currently chairman of the UMCG, started a study in 2005 to investigate whether radiotherapy in patients with metastasis in the sentinel node is a good alternative to surgery in which all lymph nodes are removed.
From the start of the study to 2016, a total of 1,535 patients from 59 hospitals in 11 countries have been involved in the study. This international effort over this long period was necessary because vulvar cancer is a rare condition.
Fewer side effects
The research now shows that for patients with metastases smaller than 2 millimeters, radiation treatment is a good alternative to surgery in which all lymph nodes are removed. The patients who underwent this treatment have fewer side effects of the treatment, while the results of the treatment are equal to the results of the current treatment.
For patients with metastasis in the sentinel node larger than 2 millimeters, radiation alone was insufficient. The UMCG is starting a follow-up study for these patients, to see whether a treatment of radiation in combination with chemotherapy offers a solution.
Huge step forward
‘This is great news for patients’, explains UMCG researcher Maaike Oonk in a press release. She led the research together with Ate van der Zee. ‘With the current treatment, the risk of side effects is very high. This new treatment is a huge step forward. We expect that this will soon become the new standard, that is now the next step.’
The results of the study are
published
in het Journal of Clinical Oncology.
