Long-Term Outcomes, Morbidity and Quality of Life in Node-Negative Early-Stage Vulvar Cancer: Sentinel Node Biopsy versus Inguinofemoral Lymphadenectomy.

OBJECTIVE: To compare recurrence, survival, morbidity, and quality of life in early-stage vulvar cancer patients with tumour-free lymph nodes undergoing sentinel lymph node biopsy (SNB) versus inguinofemoral lymphadenectomy (IFL). STUDY DESIGN: A total of 74 vulvar cancer patients (SNB: n = 58; IFL: n = 16) with a tumour size of < 4 cm and tumour-free lymph nodes were included. Endpoints were overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). DFS was further divided into local, inguinal, or distant recurrence. Additionally, morbidity and quality of life were analysed. RESULTS: No significant differences in survival outcomes were observed after a median follow-up of 58.0 months for OS, 59.1 months for DSS, and 40.0 months for DFS. Inguinal recurrences occurred in two patients in the SNB group (3.77%) and in none of the patients in the IFL group (0%). However, DFS related to isolated inguinal recurrence did not differ significantly between the groups (96.2% vs. 100%, p = 0.374). Complications were less frequent following SNB, with a significant difference observed only for lymphocele formation (13.8% vs. 50%; p = 0.02). Quality of life scores did not differ significantly between the groups. CONCLUSION: This study confirms SNB as an oncologically safe procedure. Although inguinal recurrences were slightly more frequent after SNB, there was no significant difference in DSS, DFS, or OS. Lymphocele was significantly more common after IFL, without impacting self-reported quality of life.