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Conservative and individualized surgery for early squamous carcinoma of the vulva: the treatment of choice for stage I and II (T1-2N0-1M0) disease.
Gynecol Oncol. 1994 Apr; 53(1):55-8.GO

Abstract

We studied the outcome of patients undergoing radical local excision (modified radical vulvectomy) with inguinal-femoral lymphadenectomy through separate groin incisions for stage I and II invasive squamous carcinoma 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 excision and modified radical vulvectomy in stage I disease (Obstet. Gynecol. 63, 155 (1984)) and with separate groin incisions (Obstet. Gynecol. 58, 574 (1981)). This current report expands our experience with stage I and adds stage II patients treated over the past decade. Seventy-four patients were studied retrospectively over the 5-year period ending in January 1990. Reviews of both patient charts and histopathology reports were correlated with recurrence and survival. Factors analyzed included FIGO stage and grade, histology, lesion size and depth of invasion, surgical procedure, radiotherapy, lymph node status, interval to and site of recurrence, and survival. Thirty-nine patients had stage I disease and 35 had stage II. The primary operation was a radical local excision (modified radical vulvectomy) in 56 patients and radical vulvectomy in 18 patients; 13 underwent ipsilateral inguinal-femoral lymphadenectomy and 58 bilateral lymphadenectomy, each through separate groin incisions. The survival of those treated conservatively (97 and 90% for stages I and II, respectively) is the same as those undergoing a radical vulvectomy (100 and 75% for stages I and II, respectively) with only the presence of inguinal-femoral lymph node metastases impacting negatively on survival. In the entire group, the survival for negative and positive nodes was 98 and 45%, respectively. In conclusion, conservative, modified, and individualized vulvectomy in both stage I and II disease is associated with the same outcome and survival as radical vulvectomy, and lymph node status is the most important prognostic factor.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, UCLA School of Medicine, Jonsson Comprehensive Cancer Center 90024.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8175023

Citation

Farias-Eisner, R, 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, vol. 53, no. 1, 1994, pp. 55-8.
Farias-Eisner R, Cirisano FD, Grouse D, 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. Gynecol Oncol. 1994;53(1):55-8.
Farias-Eisner, R., Cirisano, F. D., Grouse, D., Leuchter, R. S., Karlan, B. Y., Lagasse, L. D., & Berek, J. S. (1994). 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), 55-8.
Farias-Eisner R, 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. Gynecol Oncol. 1994;53(1):55-8. PubMed PMID: 8175023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conservative and individualized surgery for early squamous carcinoma of the vulva: the treatment of choice for stage I and II (T1-2N0-1M0) disease. AU - Farias-Eisner,R, AU - Cirisano,F D, AU - Grouse,D, AU - Leuchter,R S, AU - Karlan,B Y, AU - Lagasse,L D, AU - Berek,J S, PY - 1994/4/1/pubmed PY - 1994/4/1/medline PY - 1994/4/1/entrez SP - 55 EP - 8 JF - Gynecologic oncology JO - Gynecol Oncol VL - 53 IS - 1 N2 - We studied the outcome of patients undergoing radical local excision (modified radical vulvectomy) with inguinal-femoral lymphadenectomy through separate groin incisions for stage I and II invasive squamous carcinoma 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 excision and modified radical vulvectomy in stage I disease (Obstet. Gynecol. 63, 155 (1984)) and with separate groin incisions (Obstet. Gynecol. 58, 574 (1981)). This current report expands our experience with stage I and adds stage II patients treated over the past decade. Seventy-four patients were studied retrospectively over the 5-year period ending in January 1990. Reviews of both patient charts and histopathology reports were correlated with recurrence and survival. Factors analyzed included FIGO stage and grade, histology, lesion size and depth of invasion, surgical procedure, radiotherapy, lymph node status, interval to and site of recurrence, and survival. Thirty-nine patients had stage I disease and 35 had stage II. The primary operation was a radical local excision (modified radical vulvectomy) in 56 patients and radical vulvectomy in 18 patients; 13 underwent ipsilateral inguinal-femoral lymphadenectomy and 58 bilateral lymphadenectomy, each through separate groin incisions. The survival of those treated conservatively (97 and 90% for stages I and II, respectively) is the same as those undergoing a radical vulvectomy (100 and 75% for stages I and II, respectively) with only the presence of inguinal-femoral lymph node metastases impacting negatively on survival. In the entire group, the survival for negative and positive nodes was 98 and 45%, respectively. In conclusion, conservative, modified, and individualized vulvectomy in both stage I and II disease is associated with the same outcome and survival as radical vulvectomy, and lymph node status is the most important prognostic factor. SN - 0090-8258 UR - https://www.unboundmedicine.com/medline/citation/8175023/Conservative_and_individualized_surgery_for_early_squamous_carcinoma_of_the_vulva:_the_treatment_of_choice_for_stage_I_and_II__T1_2N0_1M0__disease_ DB - PRIME DP - Unbound Medicine ER -