In patients with cancer of the vulva or labia, the tumor is removed standardly. The so-called sentinel node procedure is performed for tumors less than 4 centimeters in size: an operation in which not all lymph nodes are removed, but only the first lymph node stations from the groin or groin.
When the sentinel node contains metastasis, all lymph nodes from the groin or groin are removed during a second operation. This procedure is associated with many short- and long-term side effects, such as problems with wound healing, inflammation and the development of lymphedema in the legs.
59 hospitals in 11 countries
Ati van der Zee, currently chair of the UMCG board of directors, began a study in 2005 to investigate whether radiotherapy for patients with sentinel node metastasis is a good alternative to surgery in which all lymph nodes are removed.
From the start of the study until 2016, a total of 1,535 patients from 59 hospitals in 11 countries participated in the study. This international effort during such a long period was necessary because vulvar cancer is a rare condition.
Fewer side effects
Research now shows that for patients with metastases smaller than 2 mm, radiotherapy is a good alternative to surgery in which all lymph nodes are removed. Patients who have undergone this treatment have fewer side effects of the treatment, while the results of the treatment equal the results of the current treatment.
For patients with sentinel node metastasis greater than 2 mm in size, radiation alone was insufficient. UMCG is starting a follow-up study of these patients, to see if radiation therapy with chemotherapy offers a solution.
A big step forward
“This is great news for patients,” UMCG researcher Maaike Oonk explains in a press release. She led the research with Ate van der Zee. With current treatment, the risk of side effects is very high. This new treatment is a huge step forward. We expect this to become the new standard soon, and now that’s the next step.
In the Journal of Clinical Oncology.
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