Recent trends in surgical and reconstructive management of vulvar cancer: review of literature

Abstract

Vulvar cancer (VC) is a rare disease. The most common histologic type is squamous-cell carcinoma. VC could be divided into two types: type one, commonly associated with HPV infection, occurs in young women and type two, associated with non-neoplastic lesions that usually occurs in older women. Previously VC was often treated with radical Vulvectomy. Today update in diagnostic and surgery technique, capable to identify early stages of disease and adaptation in surgery procedures, according to the stage of disease, age of patients and possible physical and psychological morbidity consequence, allow using less radical surgery approaches. That has led to decrease therapy-associated morbidity while preserving oncologic safety and improving psychosexual outcomes. Finally, several surgical treatments are available in case of VC and, despite radical surgery is often required, less radical surgery associated with reconstructive plastic surgery decreases some of short- and long-term associated complications.

Target Therapies for Uterine Carcinosarcomas: Current Evidence and Future Perspectives

“…Despite surgical cytoreduction and subsequent chemotherapy being considered the best primary treatment for uterine CS, the overall five-year survival rate is 30 ± 9% for all stages and recurrence is very common (50–80%) [5,6,38]. The characteristics of uterine CS are very different from other types of gynecological cancer, such as ovarian [79,80,81,82,83,84,85], endometrial [86,87], cervical [88,89] and vulvar [90,91] cancers. The atypical pathogenesis and poor prognosis of uterine CS, despite the aggressive conventional treatments, have pushed researchers to understand the molecular basis of CS, with the aim to individuate new and effective methods of target treatment.…”

Psychological impact of fertility preservation techniques in women with gynaecological cancer

“…It usually occurs in older women but it can also appear in younger women [1]. Treatment is surgical with or without adjuvant radiotherapy [14]. …”

Trends and Complications of Vulvar Reconstruction After Vulvectomy: A Study of a Nationwide Cohort

“…However, more data would be needed to confirm this trend. 35 This study contributes to the current body of knowledge by using a national database to show that reconstruction is a risk factor for readmission and significant postoperative complications in those undergoing vulvar excision, even after controlling for potential confounders. These results emphasize the need for careful patient selection and efforts to optimize surgical readiness when selecting reconstructive candidates.…”

“…33,34 Although limited institutional experiences with various closure techniques have been reported, large-scale analysis of outcomes and trends in reconstruction compared with primary closure have not been well reported in the literature. 35,36 This study aims to use the National Surgical Quality Improvement Program (NSQIP) database, provided by the American College of Surgeons, to evaluate complications surrounding vulvar reconstruction compared with primary closure, and trends in reconstruction after surgical excision of vulvar cancer.…”