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

Meelapkij, Panida; Suprasert, Prapaporn; Baisai, Orthai

doi:10.1155/2018/4723167

Cited by 7 publications

(10 citation statements)

References 34 publications

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“…The 5 years disease-free survival is 66%, which is comparable to the studies published by Sharma DN. et al [13], Singh N. et al [21], Rajshree D K. et al [22], and Meelapkij P. et al [23]. There are no large randomized controlled trials or meta-analysis because of the rarity of the disease.…”

Section: Discussionmentioning

confidence: 99%

Vulvar cancer: surgical management and survival trends in a low resource setting

Kumar

Ray

Sharma

et al. 2020

J Egypt Natl Canc Inst

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Background: This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May 2014 to June 2019. Results: The mean age of VC diagnosis was 55 years, with a range of 38-84 years. The incidence was four cases per year. The disease incidence was significantly more in post-menopausal (65%) and multiparous (90%) women. According to FIGO staging of vulvar cancer, stages I, II, and III were assigned to 6, 1, and 11 patients respectively. Two patients suffered from stage IVa vulvar melanoma. All patients had undergone surgical interventions. Patients treated with only nonsurgical (chemotherapy/radiotherapy/chemo-radiotherapy) treatment modalities were excluded from the study. Fifteen patients were treated with wide local excision (WLE), bilateral inguinofemoral dissection (B/L IFLND), and primary repair. Four and one patients were treated with radical vulvectomy (RV) and modified radical vulvectomy (MRV) [with or without B/L IFLND and PLND] respectively. Reconstruction with V-Y gracilis myocutaneous and local rotation advancement V-Y fasciocutaneous flaps were done in two patients. Therapeutic groin nodal dissection was performed in 19 patients except in one patient who was treated by palliative radical vulvectomy. In the final histopathology reports, tumor size varies from 0.5 to 6.5 cm (mean 3.35 cm) with the predominance of squamous cell carcinoma (18 out of 20 patients). Only 10 out of 18 eligible patients received adjuvant treatment. Poor patient compliance has been one of the major reasons for adjuvant treatment attrition rate. Systemic and loco-regional metastasis occurred in 3 patients each arm respectively. Poor follow up of patients is the key limitation of our study. Conclusion: Vulvar cancer incidence was significantly high in post-menopausal and multiparous women. The most important prognostic factors were tumor stage and lymph node status. Oncological resection should be equated with functional outcome. The multidisciplinary team approach should be sought for this rare gynecological malignancy.

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Section: Discussionmentioning

confidence: 99%

Vulvar cancer: surgical management and survival trends in a low resource setting

Kumar

Ray

Sharma

et al. 2020

J Egypt Natl Canc Inst

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“…This may be due to the difference of the study designs or different age groups and adjuvant treatment regimens. Meelapkij et al [24] examined 145 patients with vulvar SCC and detected 5-year survival rate as 50.8%. Although the study population was elder in our study, the 5-year survival rate was found to be higher.…”

Section: Discussionmentioning

confidence: 99%

The effect of lymph node metastasis on overall survival and disease-free survival in vulvar cancer patients

et al. 2020

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Objectives: To examine the effect of lymphadenectomy on survival in patients with squamous cell vulvar carcinoma. Material and methods: Patients with squamous cell vulvar cancer who underwent surgery were retrospectively analyzed. All procedures were performed according to current recommendations/standard of treatment. The clinical and pathological features were examined. Sixty-eight patients were studied. The mean age was 64.7 ± 10.9 years. Twenty-three (33.8%) patients had nodal metastasis. Most patients (60.3%) were in stage IB. Adjuvant radiotherapy and chemo-radiotherapy were administered to 33.8% and 25% of the patients, respectively. The median follow-up time was 28.5 (4-183) months. Recurrence occurred in 18 (26.5%) cases. Results: There was no significant difference between node-positive and node-negative patients in terms of age, number of dissected lymph nodes and recurrence. Tumor diameter was significantly higher in the metastatic group. Age and surgical margin positivity were independent prognostic factors for overall survival (OS). Surgical margin positivity and lymph node metastasis had no effect on disease-free survival (DFS). Conclusions: Our results showed that age and surgical margin positivity were independent prognostic factors for OS. Although surgical margin positivity increased the risk of recurrence in univariate analysis, it was not a significant factor affecting DFS. OS was significantly lower in patients with lymph node metastasis.

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“…Carcinoma of the vulva is a rare tumour, accounting for 4% of all gynaecological malignancies, with an incidence of two to seven cases per 100,000 women. In about 90% of cases the histological type is SCC [1] , which includes two aetiological subtypes with bimodal distribution. The classic type is related to human papilloma virus (HPV) infection, occurs in younger women and is associated with high-risk sexual activity.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia and Extensive Chest Metastasis of Vulvar Squamous Cell Carcinoma

Mota

Mesquita

Pires

et al. 2019

European Journal of Case Reports in Internal Medicine

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A 73-year-old woman with a diagnosis of vulvar carcinoma submitted to curative surgery 5 years previously, presented to the emergency department with prostration and vulvar haemorrhage. Although the gynaecological examination was unremarkable, she had a mass in the left chest wall and hypercalcemia. A CT scan of the thorax revealed a voluminous left hemithorax mass invading the mediastinum, lung, pleura and chest wall. Ultrasound-guided biopsy of the mass showed infiltration by a well-differentiated keratinizing squamous cell carcinoma (SCC). This case report describes an extremely rare metastatic pattern in vulvar SCC concomitant with paraneoplastic hypercalcemia.

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

Cited by 7 publications

References 34 publications

Vulvar cancer: surgical management and survival trends in a low resource setting

Vulvar cancer: surgical management and survival trends in a low resource setting

The effect of lymph node metastasis on overall survival and disease-free survival in vulvar cancer patients

Hypercalcemia and Extensive Chest Metastasis of Vulvar Squamous Cell Carcinoma

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