Changing concepts in the management of vulvar cancer

Thomas, Gillian; Dembo, A.J.; Bryson, S.C.Peter; Osborne, R.; DePetrillo, A.D.

doi:10.1016/0090-8258(91)90223-r

Cited by 90 publications

(58 citation statements)

References 29 publications

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“…At present, the standard treatments for vulvar neoplasms are radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Studies of neoadjuvant radiotherapy aiming to shrink lesions that would have otherwise required pelvic exenteration, have suggested that radiotherapy may be used to reduce the extent of subsequent surgery or eradicate the disease in certain patients (2)(3)(4). Furthermore, concomitant radiotherapy and chemotherapy with 5-fluorouracil (5-FU) improved regression of various squamous cell carcinomas of the anus, esophagus, head, neck and cervix (3).…”

Section: Introductionmentioning

confidence: 99%

“…A number of retrospective analyses have established the feasibility of this new therapeutic approach, and suggested a therapeutic benefit of induction chemoradiation therapy for the treatment of vulvar neoplasms (2,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The majority of studies involved patients with locally advanced vulvar neoplasms, but certain studies also included recurrent tumor cases that were not eligible for surgical resection by radical vulvectomy.…”

Section: Introductionmentioning

confidence: 99%

“…Vulvar neoplasms are an uncommon type of tumor accounting for only 3 to 5% of all gynecological cancers (1,2); therefore, studies on the management of this type of cancer are scarce. At present, the standard treatments for vulvar neoplasms are radical vulvectomy and bilateral inguino-femoral lymphadenectomy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

Gaudineau¹,

Weitbruch²,

Quétin³

et al. 2012

Oncology Letters

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

Gaudineau¹,

Weitbruch²,

Quétin³

et al. 2012

Oncology Letters

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“…Irradiation to doses of 50 Gy is an effective alternative to electively treat the regional nodes (27). If palpable inguinal lymph nodes are present, a lymphadenectomy is preferred, followed by 50 Gy to the inguinal-femoral and pelvic nodes.…”

Section: P-value -------------------------------------------------mentioning

confidence: 99%

Prophylactic inguinal-femoral irradiation as an alternative to primary lymphadenectomy in treatment of vulvar carcinoma

Hallak

Ladi²,

Sorbe

2007

Int J Oncol

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Abstract. In a complete geographic series of 294 cases of primary vulvar carcinomas prophylactic inguinal-femoral irradiation was used as a standard postoperative therapy. Inguinal lymph node dissection was performed in only 27 cases (9%) and was not part of the standard surgery. The histology was squamous cell carcinoma in 269 cases (92%). The primary surgery was total vulvectomy, partial vulvectomy, or local resection of the tumor. The main type of radiotherapy was adjuvant inguinal irradiation. Two separate, symmetrical and rectangular inguinal fields were irradiated with combined photon and electron beams. In the complete series 127 recurrences (43%) were recorded. Local (24%) and regional recurrences (19%) were most frequent. Type of surgery was not associated with the risk of tumor recurrence. The 5-year overall survival rate was 53% and the relapse-free survival (RFS) rate was 55%. Tumor grade was significantly (P=0.007) associated with the RFS. The inguinal RFS rate was 75% both for patients treated with adjuvant inguinal irradiation without lymphadenectomy and patients treated with primary lymphadenectomy ± inguinal irradiation. Postoperative complications were recorded in 22%. Postoperative complications occurred most frequently in the subgroup undergoing inguinal lymphadenectomy. Chronic lymph edemas were the most serious late tissue reactions.

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“…Squamous cell cancer type accounts for 90%. 4 Uremia from ureteric obstruction due to enlarged common ileac and paraaortic nodes, rupture of femoral vessels and sepsis are main causes of death of vulval cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Perioperative morbidity of Vulval cancer

2020

IJOGR

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Introduction: The present study is a retrospective analysis of vulval cancer patients who had been treated with surgery as primary mode. The cases studied were in tertiary care hospital south India of March 2008 to February 2013. Total number of patients was 11. Materials and Methods: The medical records of all patients studied retrospectively with reference to stage of the disease, surgery performed, prophylactic antibiotics, intra-operative and postoperative complications. Results: Among 11 patients 9 were postmenopausal. Ten patients histopathology showed stage 1b cancer for whom simple vulvectomy was performed, one patient had co-existing HGSIL( High Grade Squamous Intraepithelial Lesion) and positive right inguinal nodes, requiring TAH+ BSO+ right groin dissection and posterior colporrhaphy was done in one patient with rectocele. One patient presented with stage 2 disease for which radical vulvectomy with bilateral groin lymph node dissection was carried out. Postoperative radiotherapy was given for 8 patients with tumor positive margins. Conclusion: Even though many modifications in surgical methods of vulval cancer still morbidity is high. Particularly surgical complication of wound infection. This delay will further add up for delay in starting adjuvant treatment. Hence there is a need of further modifications of surgical treatments like minimally invasive approach. A team of oncology surgeons, medical oncologists, radiotherapists is needed to manage this rare cancer. With multidisciplinary approach Surgery for early stage vulval cancer has acceptable morbidity.

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Changing concepts in the management of vulvar cancer

Cited by 90 publications

References 29 publications

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

Prophylactic inguinal-femoral irradiation as an alternative to primary lymphadenectomy in treatment of vulvar carcinoma

Perioperative morbidity of Vulval cancer

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