Polterauer S et al. – The lymph node ratio (LNR) is prognostic in vulvar cancer patients with inguinal LN resection, and superior to the number of positive nodes. LNR facilitates selection of appropriate candidates for adjuvant radiation.

Methods

• 745 vulvar cancer patients treated with inguinal lymphadenectomy were studied.

Results

• The mean number of resected and positive LN was 14.1 and 3.0, respectively.
• High LNR was associated with larger tumor size and higher tumor grade.
• Patients with LNRs 0% (N0), > 0 < 20%, and > 20% had 5-year overall survival (OS) rates of 90.9%, 70.7%, and 61.8%, respectively.
• LNR was associated with both local and distant recurrence-free survival.
• Patients with 0, 1, 2, 3 or > 3 positive lymph nodes had 5-year OS rates of 90.9%, 70.8%, 67.8%, 70.8% and 63.4% respectively.
• LNR and FIGO stage were associated with OS, unlike the number of positive nodes, age, and tumor grade.