CONSERVATIVE AND INDIVIDUALIZED SURGERY FOR EARLY SQUAMOUS CARCINOMA OF THE VULVA - THE TREATMENT OF CHOICE FOR STAGE-I AND II (T1-2N0-1M0)DISEASE

Citation
R. Fariaseisner et al., CONSERVATIVE AND INDIVIDUALIZED SURGERY FOR EARLY SQUAMOUS CARCINOMA OF THE VULVA - THE TREATMENT OF CHOICE FOR STAGE-I AND II (T1-2N0-1M0)DISEASE, Gynecologic oncology, 53(1), 1994, pp. 55-58
Citations number
22
Categorie Soggetti
Oncology,"Obsetric & Gynecology
Journal title
ISSN journal
00908258
Volume
53
Issue
1
Year of publication
1994
Pages
55 - 58
Database
ISI
SICI code
0090-8258(1994)53:1<55:CAISFE>2.0.ZU;2-8
Abstract
We studied the outcome of patients undergoing radical local excision ( modified radical vulvectomy) with inguinal-femoral lymphadenectomy thr ough separate groin incisions for stage I and II invasive squamous car cinoma of the vulva. The purpose was to determine whether less radical and more individualized surgery is consistent with local control and cure. We have reported previously our experience using radical local e xcision and modified radical vulvectomy in stage I disease (Obstet. Gy necol. 63, 155 (1984)) and with separate groin incisions (Obstet. Gyne col. 58, 574 (1981)). This current report expands our experience with stage I and adds stage II patients treated over the past decade. Seven ty-four patients were studied retrospectively over the 5-year period e nding in January 1990. Reviews of both patient charts and histopatholo gy reports were correlated with recurrence and survival. Factors analy zed included FIGO stage and grade, histology, lesion size and depth of invasion, surgical procedure, radiotherapy, lymph node status, interv al to and site of recurrence, and survival. Thirty-nine patients had s tage I disease and 35 had stage II. The primary operation was a radica l local excision (modified radical vulvectomy) in 56 patients and radi cal vulvectomy in 18 patients; 13 underwent ipsilateral inguinal-femor al lymphadenectomy and 58 bilateral lymphadenectomy, each through sepa rate groin incisions. The survival of those treated conservatively (97 and 90% for stages I and II, respectively) is the same as those under going a radical vulvectomy (100 and 75% for stages I and II, respectiv ely) with only the presence of inguinal-femoral lymph node metastases impacting negatively on survival. In the entire group, the survival fo r negative and positive nodes was 98 and 45%, respectively. In conclus ion, conservative, modified, and individualized vulvectomy in both sta ge I and II disease is associated with the same outcome and survival a s radical vulvectomy, and lymph node status is the most important prog nostic factor. (C) 1994 Academic Press, Inc.