Inguinal recurrence following therapeutic lymphadenectomy for node positive XXXX : outcome and implications for management.

@entity1 @entity5 @entity3 @entity13849 @entity17539
PURPOSE: We investigated the treatment results and outcomes of @entity1 with pathological node positive @entity17539 who experienced an inguinal recurrence after therapeutic lymphadenectomy, and determined the clinicopathological features predictive of such recurrences. MATERIALS AND METHODS: Data of 161 @entity1 with pN+ @entity17539 were analyzed. Ipsilateral postoperative radiotherapy was given if histopathology revealed 2 or more @entity3 and/or extranodal extension. Medium observed followup was 60 months. The 5-year incidence of inguinal recurrence was estimated using a competing risk analysis considering death a competing risk. RESULTS: An inguinal recurrence developed in 26 @entity1 following lymphadenectomy after a median of 5.3 months. The overall estimated 5-year inguinal recurrence rate was 16%. Of the 26 @entity1 with inguinal recurrence ipsilateral adjuvant radiotherapy was indicated in 22 but given in 11. The other 11 @entity1 had recurrence in the groin before the start of adjuvant radiotherapy. Median survival after inguinal recurrence was 4.5 months. Only 2 of 26 @entity1 (8%) underwent successful salvage after inguinal recurrence. Pronounced differences in estimated recurrence rates were found among several clinicopathological variables indicating extensive @entity5 . @entity1 with 3 or more unilateral metastatic inguinal nodes and/or extranodal extension and/or pelvic @entity13849 involvement defined a subgroup with high risk pN+ @entity5 . CONCLUSIONS: Most inguinal recurrence following therapeutic lymphadenectomy in pN+ @entity17539 occurs within a short time. @entity1 experiencing such a recurrence have a poor outcome with limited salvage options. @entity1 with 3 or more unilateral metastatic inguinal nodes and/or extranodal extension and/or pelvic @entity13849 involvement represent a high risk group that may benefit from multimodality treatment.
