Groin Recurrence Rates After Exclusive Indocyanine Green Sentinel Node-Mapping in Early-Stage Vulvar Cancer

Abstract Background The current study aimed to assess oncologic safety with 24-month groin recurrence rates after the exclusive use of indocyanine green (ICG) for sentinel node (SLN) detection in early-stage, node-negative vulvar cancer. Methods This retrospective cohort study descriptively assessed consecutive patients with early (T1/2 < 4 cm) squamous vulvar cancer who underwent exclusive ICG-based inguinal sentinel node-mapping without radioactive tracer or blue dye. Results Data of 49 patients encompassing 94 groins at risk were available for analysis. The SLN detection rate was 90.4% (85/94) per groin. In nine (9.6%) groins, ICG failed to identify the SLN. These patients subsequently underwent lateralized systematic lymphadenectomy. Among patients with unifocal disease and a negative SLN (63 groins at risk in 33 patients), the 24-month groin recurrence rate was 1.6% (one unilateral recurrence) per groin. Conclusion Exclusive ICG-guided SLN-mapping demonstrated a low groin recurrence rate in early-stage node-negative vulvar cancer. The study results are within the range previously reported by the GROINSS-V study after a combined radioactive tracer and blue dye approach. These findings suggest that exclusive ICG-guided SLN-mapping is feasible and may provide oncologic outcomes comparable with those reported for conventional SLN-mapping in carefully selected patients with early-stage vulvar cancer treated at a tertiary care center.