Treatment of Inoperable Vulvar Cancer

Martínez-Castro, Pedro; Poveda, Andrés; Guinot, José Luis; Minig, Lucas

doi:10.1097/igc.0000000000000815

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…Concerning the outcome of treatment, the recurrence rate occurred in 35% of the follow-up patients with the median recurrence rate at one year with the groin nodes being the most frequent recurrence site. This recurrence rate corresponded to the previous reports that were in a range of 12–37%, most of them occurring within two years [ 28 ]. The independent risk factors for local recurrences are a higher age, a multifocal tumor, a depth of invasion more than two mm, lymphovascular space invasion, and the presence of groin node dissection [ 29 ].…”

Section: Discussionsupporting

confidence: 91%

Treatment Outcomes of Patients with Squamous Cell Carcinoma of the Vulva: The Largest Series from a Tertiary Care Hospital

Meelapkij

Suprasert

Baisai

2018

Obstetrics and Gynecology International

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Objective To evaluate the outcomes of squamous cell carcinoma (SCCA) of the vulva treated at our tertiary care center. Methods The medical records of SCCA patients treated between January 2006 and December 2015 were retrospectively reviewed. Results One hundred forty-five patients met the criteria with the median age of 57 years old, and 58.6% had an underlying disease. The distribution of stages was as follows: IA 6.2%, IB 21.4%, II 26.2%, IIIA 14.5%, IIIB 6.2%, IIIC 9.7%, IVA 9.0%, and IVB 6.9%. One hundred and nine patients underwent surgical intervention and radical local excision with bilateral groin node dissection as the most frequent procedure. Approximately half of the patients received combined treatment with surgery followed by radiation with or without chemotherapy. Recurrence developed in 127 patients after the median follow-up time of one year with the common sites in the groin and vulva region. However, no significant difference in survival occurred in patients with and without groin node recurrence (15 vs. 28 months, P=0.109). The five-year overall survival was 50.8%. Conclusions The survival of patients with SCCA vulvar cancer was modest. The common failure sites were groin and vulva regions with unfavorable outcomes.

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Section: Discussionsupporting

confidence: 91%

Treatment Outcomes of Patients with Squamous Cell Carcinoma of the Vulva: The Largest Series from a Tertiary Care Hospital

Meelapkij

Suprasert

Baisai

2018

Obstetrics and Gynecology International

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“… 35 Although there were no changes in the types of surgical procedures employed during our study period, previous studies have shown changes due to the introduction of less radical surgery. 33 36 37…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Treatment of Vulvar Cancer From 2014−2018: A Nationwide Population-Based Study in Korea

et al. 2022

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Background Vulvar cancer is one of the rare gynecologic malignancies. Despite the recent increasing trend of vulvar cancer in western countries due to the increased infection of human papillomavirus, there has been no study for population-based incidence of vulvar cancer in Korea. We aimed to investigate the prevalence and treatment of vulvar cancer in South Korea between 2014 and 2018. Methods Data from patients diagnosed and treated with vulvar cancer between 2014 and 2018 were obtained from the Health Insurance Review and Assessment Service/National Inpatient Sample (National In-Patient Sample) in South Korea. Results A total of 4,636,542 women were identified through the HIRA-NIS database from 2014 to 2018, of which 259 patients were diagnosed and treated for vulvar cancer. The mean age diagnosed with vulvar cancer was 62.82 (± 14.30) years in 2014, 64.19 (± 16.79) years in 2015, and 67.40 (± 14.41) years in 2016. In terms of treatment modalities, the most frequent treatment was surgery only without chemotherapy or radiation therapy. In the age-specific prevalence analysis, vulvar cancer was the most prevalent among those over 70 years old. According to multiple regression analysis, patients’ age was significantly associated with the prevalence of vulvar cancer. Vulvar cancer was more prevalent in women with low socioeconomic status (SES) compared to those with high SES in 2018 (OR, 4.242; P < 0.001). Conclusion Considering the high prevalence of vulvar cancer in the elderly, it is necessary to establish a new strategy for early screening and treatment.

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“…Management of LAVC remains a debate topic due to the rarity of this neoplasm that develops in elderly women with important comorbidities. Treatment of inoperable vulvar cancer has significantly changed in past decades, 12 but there is no standard therapy. Mahner et al 13 and Reade et al 14 did not show superiority of any systemic treatment (neoadjuvant chemoradiation, NACT, and definitive chemoradiation).…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy followed by radical surgery in locally advanced vulvar carcinoma: a single-institution experience

Adorni

Bazzurini

Alberto

et al. 2021

Tumori

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Background: Squamous cell carcinoma of the vulva is a rare malignancy that affects elderly women. About one-third of vulvar cancers are diagnosed in an advanced stage, requiring extensive surgery. Neoadjuvant chemotherapy (NACT) has been introduced to reduce local tumor burden. In this retrospective study, we analyze the efficacy and toxicity of NACT followed by radical surgery. Methods: Patients with locally advanced vulvar cancer (LAVC) treated at our institution with neoadjuvant platinum and paclitaxel-based chemotherapy ± ifosfamide followed by surgery at our institution were retrospectively identified. Results: Fourteen patients (93%) completed NACT with tolerable toxicities (G3–G4 toxicity: 30%). Thirteen patients (87%) underwent surgery. The overall clinical response rate on vulvar disease was 66% (20% complete response, 46% partial response), confirmed by histopathologic analysis, while on inguinal lymph nodes it was 69% (23% complete response, 46% partial response). At the pathologic examination, all patients had negative surgical margins. Three out of 9 patients (33%) with lesions infiltrating the urethral meatus and 4 patients out of 7 (57%) with anal involvement did not require urethral amputation or colostomy, respectively, after NACT. No severe postoperative complications were described. Overall survival at 5 years was 60%, and median overall survival was 76 months. Conclusion: NACT followed by surgery in locally advanced vulvar cancer is well tolerated and allows surgical modulation.

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Treatment of Inoperable Vulvar Cancer

Cited by 9 publications

References 37 publications

Treatment Outcomes of Patients with Squamous Cell Carcinoma of the Vulva: The Largest Series from a Tertiary Care Hospital

Treatment Outcomes of Patients with Squamous Cell Carcinoma of the Vulva: The Largest Series from a Tertiary Care Hospital

Prevalence and Treatment of Vulvar Cancer From 2014−2018: A Nationwide Population-Based Study in Korea

Neoadjuvant chemotherapy followed by radical surgery in locally advanced vulvar carcinoma: a single-institution experience

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