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Ginecología y obstetricia de México
Print version ISSN 0300-9041
Abstract
TORRES-LOBATON, Alfonso et al. Vulvar cancer. Impact of surgical treatment: experience with 151 patients. Ginecol. obstet. Méx. [online]. 2018, vol.86, n.7, pp.423-433. ISSN 0300-9041. https://doi.org/10.24245/gom.v86i7.2187.
Objective:
The present study is a review of our experience of the surgical options for vulvar cancer using The International Federation of Gynecology and Obstetrics (FIGO) classification.
Materials and methods:
Retrospective analysis of records of patients diagnosed with vulvar carcinoma operated with or without coadyuvance in the Oncology service of the General Hospital of Mexico in a span of 34 years. For the statistical analysis, the Epi Info version 7.2 program was used.
Results:
Patients were divided into groups, those with pre-invasion or minimal invasion disease were resolved with local excision or simple vulvectomy 24 (16%). Patients with invasive cancer were treated with conservative surgery with or without unilateral lymph node dissection 16 (15%); radical vulvectomy with inguino femoral lymphadenectomy 94 (62%) (47 block surgeries and 47 with separate incision); ultra-radical surgery 11 (7%) (6 abdomino-perineal resections and 5 pelvic exenterations). 127 patients had follow-up and 62 of them had a disease-free survival rate of 30 months (48.8%). The overall survival in pre-invasion or minimal invasion disease were 91.3% (21/23), in stage IB-II 75.5% (37/49), in stage III 31.7% (13/41) (p=0.00007) and in stage IVA 21.4% ( 3/14 ).
Conclusions:
Although a more individualized and less radical treatment is suggested, in this series only 14.5% of patients, could be resolved with conservative surgery. In addition, the lymph node status was the most important prognostic factor for survival.
Keywords : Vulvar cancer; Vulvectomy; Unilateral lymph node dissection; Limphadenectomy; Pelvic exenterations.