Inguinal Lymph Node Dissection for Lower Limb Cancer: Indications, Technics and Results about 70 Cases

Background: Inguinal lymph node dissection helps to prevent groin and systemic metastasis during surgery for limb and lower genitourinary cancers. The objective of this work was to report the indications, techniques and results of inguinal lymph node dissection in cancers of the lower limb at the Dakar Cancer Institute. Methods: This was a retrospective study over a 7-year period. Included patients were over 15 years of age and had lower limb cancer regardless of the tissue involved. The parameters studied were age, gender, histological type, lymph node involvement, postoperative morbidity, recurrence and survival. Results: There were 70 patients operated over a period of 7 years. The average age of our patients was 53.4 years. The sex ratio was 0.94 with 34 men and 36 women. The most common histological type was squamous cell carcinoma with 30 cases (42.8%). There were more clinical and histological involved nodes in the case of sarcomas. Histological findings were done in 26 of 54 patients (48%). We noted 3 cases of death (4.2%) in a context of kidney failure for 1 case and respiratory distress 2 cases. The local complications consisted of suture release in 2 cases, 1 operative wound necrosis, 1 amputation wound suppuration. After five years of follow up, no patients had chronic sequels following inguinal dissection, 5 patients (7.7%) had local recurrence, 4 patients (7.7%) had node metastases and 1 patient developed liver metastases. We have recorded 20 deaths (28.6%) related to cancer. Conclusions: Inguinal lymph node dissection showed good results in limb cancer treatment. Squamous cell carcinoma is the main histologic cancer and lymph involvement is more frequent in case of sarcomas. Complications are rare and death occurred mostly for related to cancer stage.