Selective inguinofemoral node dissection for stage III vulvar squamous cancer: feasibility and safety

To assess the feasibility and outcomes of selective inguinal lymph node dissection (ILND) in stage III vulvar squamous cancer. This study was approved by the Committee of Fudan University Shanghai Cancer Center. Ninety-one patients with stage III vulvar squamous cancer between 3/2018 and 3/2021 were included in this study. Thirty-one patients chose radical excision with selective ILND while 60 patients received radical excision with complete ILND voluntarily. After surgery, all the patients received postoperative external beam radiotherapy (EBRT). All the patients were invited to fill out two questionnaires: the EORTC QLQ-C30 and a vulvar specific questionnaire. The median follow-up time was 34 (16-50) months. There was no statistical difference in recurrence (p>0.05) or overall survival (p>0.05) in the two groups. Moreover, no difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of edema and body image after complete ILND. Patients who underwent selective ILND reported less treatment related morbidity without affecting survival and overall quality of life compared to those who underwent complete ILND. Selective ILND may be a reasonable alternative for stage III vulvar squamous cancer in the future.