Recurrent squamous cell carcinoma of the vulva

Preti, Mario; Ronco, Guglielmo; Ghiringhello, Bruno; Micheletti, Leonardo

doi:10.1002/(sici)1097-0142(20000415)88:8<1869::aid-cncr16>3.0.co;2-u

Cited by 74 publications

(9 citation statements)

References 20 publications

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“…In the same year, Iversen proved that the unilateral localized cancer of the vulva had bilateral lymphogenic metastases in 15%; whereas Stehman suggested inguinofemoral unilateral lymphadenectomy to be performed after wide excision of the tumor with negative edges [11,12]. Bilateral inguinofemoral lymp- hadenectomy is performed when cancers are closer to the center line of the vulva with the localization of the clitoris or perineum, and the depth of invasion is over 1 mm, while unilateral lymphadenectomy is indicated in well-differentiated tumors without penetration into the lymphatic and vascular system with negative lymph nodes on the side of the tumor [13][14][15]. This study presents the results of surgical treatment of invasive cancer of the vulva performed at the Surgical Ward, Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period from 2000 to 2010 and compares them with the results obtained at the same institution in the period from 1985 to 1999 [2].…”

Section: Discussionmentioning

confidence: 80%

Surgical treatment of invasive vulvar cancer

et al. 2012

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This paper presents the surgical treatment of invasive cancer of the vulva at the Department of Gynecology and Obstetrics inNovi Sad in the period from 2000 to 2010. Forty-one patients underwent different surgical procedures depending on their stage of the disease, age and general physical condition assessed according to the International Federation of Gynecologists and Obstetricians: wide excision to the healthy area with negative edges of 10 mm, simplex--radical vulvectomy or hemivulvectomy, block dissection of the vulva by Way, one-sided or bilateral lymphadenectomy and skin-muscle flap to cover the resulting skin defects. The number of removed lymph nodes on one side ranged from 8 to 19, the average being 12.6. Various postoperative complications (inflammation and wound dehiscence, lymphorrhoea, lymphocyst and limb lymphedema) developed in 9 (21.9%) and the local regional recurrence was recorded in 7 (17%) patients. The outcome was lethal in 4 (9.8%) surgically treated women. The primary surgical procedure is always individually planned and the choice of individual plans depends on three main factors: the size and position of the primary tumor in relation to the center line of the vulva (clitoral area--anus) and the involvement of regional lymph nodes. In order to reduce the psychosexual morbidity the preference is nowadays widely given to the local excision with adequate and histopathologically confirmed negative edges of the tumor together with determining the presence of metastases in sentinel lymph nodes.

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Section: Discussionmentioning

confidence: 80%

Surgical treatment of invasive vulvar cancer

et al. 2012

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“…From our series, a predictive factor of re-occurrence of vulvar cancer was benign or precancerous vulvar pathology (16,17) .…”

Section: Conclusion and Discussionmentioning

confidence: 80%

“…Six women had VIN 2–3 at margins or during disease‐free interval on Pap smear. Preti et al recently identified presence of VIN 2–3 in resected margins as an independent risk factor for local recurrence (17,19) . Yang and Hart described that simplex or differentiated variant of VIN was closely associated with invasive squamous cell cancer (20) .…”

Section: Conclusion and Discussionmentioning

confidence: 99%

Aggressive locally recurrent vulvar cancer: review of cases presented to Massachusetts General Hospital 1990 to present

Spiryda

Fuller

Goodman

2005

Int J Gynecol Cancer

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Isolated recurrences of squamous cell vulvar carcinoma treated by surgical re-excision have excellent outcomes. There is a subset of these patients who develop multiple local recurrences that are difficult to manage and have a high risk of dying from their cancers. We reviewed women presenting with vulvar cancer (200 patients) to Massachusetts General Hospital from 1990 to present and identified 12 women with aggressive, locally recurrent squamous cell carcinomas of the vulva. The identified women all had successful primary radical vulvectomy and groin node dissections with negative surgical margins (except patient 2) and lymph nodes with no lympho-vascular space invasion. Seven women had underlying lichen sclerosis. Eight had a history of vulvar intraepithelial neoplasia or persistent carcinoma in situ. Ten patients had greater than three recurrences after primary surgical therapy. One died of recurrent vulvar cancer 10 months after her initial diagnosis. Two patients died after three recurrences. The only unifying clinicopathologic factor among these women was persistent lichen sclerosis and persistent carcinoma in situ. Understanding the underlying mechanisms that predisposed these premalignant lesions to transform into carcinomas will help predict in which women these are likely to re-occur and may help determine which women require more aggressive initial treatment.

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“…The prognostic significance of adjacent lesions in the setting of vulvar cancer has already been studied. Before the new classification of epithelial disorders proposed by the ISSVD in 2004 [10], the presence of VIN in adjacent lesions had been identified as a predictor of reduced disease-free survival, even before using the recent classification of epithelial disorders [24]. However, in 2001, Rouzier et al showed that the presence of HPV-related VIN was a positive prognostic factor [9].…”

Section: Discussionmentioning

confidence: 99%

Associated Lichen Sclerosis Increases the Risk of Lymph Node Metastases of Vulvar Cancer

Dabi

Gosset

Bastuji‐Garin

et al. 2020

JCM

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The most important prognostic factor in vulvar cancer is inguinal lymph node status at the time of diagnosis, even in locally advanced vulvar tumors. The aim of our study was to identify the risk factors of lymph node involvement in these women, especially the impact of lichen sclerosis (LS). We conducted a retrospective population-based cross-sectional study in two French referral gynecologic oncology institutions. We included all women diagnosed with a primary invasive vulvar cancer. Epithelial alteration adjacent to the invasive carcinoma was found in 96.8% (n = 395). The most frequently associated was LS in 27.7% (n = 113). In univariate analysis, LS (p = 0.009); usual type VIN (p = 0.04); tumor size >2 cm and/or local extension to vagina, urethra or anus (p < 0.01), positive margins (p < 0.01), thickness (p < 0.01) and lymphovascular space invasion (LVSI) (p < 0.01) were significantly associated with lymph node involvement. In multivariate analysis, only LS (OR 2.3, 95% CI [1.2–4.3]) and LVSI (OR 5.6, 95% CI [1.7–18.6]) remained significantly associated with positive lymph node. LS was significantly associated with older patients (p = 0.005), anterior localization (p = 0.017) and local extension (tumor size > 2 cm: p = 0.001). LS surrounding vulvar cancer is an independent factor of lymph node involvement, with local extension and LVSI.

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Recurrent squamous cell carcinoma of the vulva

Cited by 74 publications

References 20 publications

Surgical treatment of invasive vulvar cancer

Surgical treatment of invasive vulvar cancer

Aggressive locally recurrent vulvar cancer: review of cases presented to Massachusetts General Hospital 1990 to present

Associated Lichen Sclerosis Increases the Risk of Lymph Node Metastases of Vulvar Cancer

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