Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas
Identifieur interne : 00DB00 ( Main/Curation ); précédent : 00DA99; suivant : 00DB01Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas
Auteurs : Jacob Rotmensch [États-Unis] ; Steven J. Rubin [États-Unis] ; Harold G. Sutton [États-Unis] ; Ghodratollah Javaheri [États-Unis] ; Howard J. Halpern [États-Unis] ; Jeffrey L. Schwartz [États-Unis] ; Michael Stewart [États-Unis] ; Ralph R. Weichselbaum [États-Unis] ; Arthur L. Herbst [États-Unis]Source :
- Gynecologic Oncology [ 0090-8258 ] ; 1990.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Association thérapeutique, Carcinome épidermoïde (), Carcinome épidermoïde (anatomopathologie), Carcinome épidermoïde (radiothérapie), Femelle, Humains, Lésions radio-induites, Noeuds lymphatiques (), Soins préopératoires, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs de la vulve (), Tumeurs de la vulve (anatomopathologie), Tumeurs de la vulve (radiothérapie), Vulve (), Études de suivi.
- MESH :
- anatomopathologie : Carcinome épidermoïde, Tumeurs de la vulve.
- radiothérapie : Carcinome épidermoïde, Tumeurs de la vulve.
- Adulte, Adulte d'âge moyen, Association thérapeutique, Carcinome épidermoïde, Femelle, Humains, Lésions radio-induites, Noeuds lymphatiques, Soins préopératoires, Sujet âgé, Sujet âgé de 80 ans ou plus, Tumeurs de la vulve, Vulve, Études de suivi.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell (pathology), Carcinoma, Squamous Cell (radiotherapy), Carcinoma, Squamous Cell (surgery), Combined Modality Therapy, Female, Follow-Up Studies, Humans, Lymph Nodes (surgery), Middle Aged, Preoperative Care, Radiation Injuries, Vulva (surgery), Vulvar Neoplasms (pathology), Vulvar Neoplasms (radiotherapy), Vulvar Neoplasms (surgery).
- MESH :
- pathology : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- radiotherapy : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- surgery : Carcinoma, Squamous Cell, Lymph Nodes, Vulva, Vulvar Neoplasms.
- Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Preoperative Care, Radiation Injuries.
Abstract
A therapeutic alternative to exenteration for large locally advanced vulvar carinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.
Url:
DOI: 10.1016/0090-8258(90)90169-L
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<term>Carcinoma, Squamous Cell (radiotherapy)</term>
<term>Carcinoma, Squamous Cell (surgery)</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Lymph Nodes (surgery)</term>
<term>Middle Aged</term>
<term>Preoperative Care</term>
<term>Radiation Injuries</term>
<term>Vulva (surgery)</term>
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<term>Vulvar Neoplasms (radiotherapy)</term>
<term>Vulvar Neoplasms (surgery)</term>
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<term>Association thérapeutique</term>
<term>Carcinome épidermoïde ()</term>
<term>Carcinome épidermoïde (anatomopathologie)</term>
<term>Carcinome épidermoïde (radiothérapie)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lésions radio-induites</term>
<term>Noeuds lymphatiques ()</term>
<term>Soins préopératoires</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tumeurs de la vulve ()</term>
<term>Tumeurs de la vulve (anatomopathologie)</term>
<term>Tumeurs de la vulve (radiothérapie)</term>
<term>Vulve ()</term>
<term>Études de suivi</term>
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<term>Tumeurs de la vulve</term>
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<term>Vulvar Neoplasms</term>
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<keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Vulvar Neoplasms</term>
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<keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Carcinome épidermoïde</term>
<term>Tumeurs de la vulve</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Lymph Nodes</term>
<term>Vulva</term>
<term>Vulvar Neoplasms</term>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Preoperative Care</term>
<term>Radiation Injuries</term>
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<term>Adulte d'âge moyen</term>
<term>Association thérapeutique</term>
<term>Carcinome épidermoïde</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lésions radio-induites</term>
<term>Noeuds lymphatiques</term>
<term>Soins préopératoires</term>
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<front><div type="abstract" xml:lang="en">A therapeutic alternative to exenteration for large locally advanced vulvar carinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.</div>
</front>
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<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea>Department of Radiation Oncology, The University of Chicago, Chicago Lying-In Hospital, Chicago</wicri:cityArea>
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<author><name sortKey="Herbst, Arthur L" sort="Herbst, Arthur L" uniqKey="Herbst A" first="Arthur L." last="Herbst">Arthur L. Herbst</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
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<wicri:cityArea>Department of Obstetrics and Gynecology, The University of Chicago, Chicago Lying-In Hospital, Chicago</wicri:cityArea>
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<series><title level="j">Gynecologic Oncology</title>
<title level="j" type="abbrev">YGYNO</title>
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<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1990">1990</date>
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<biblScope unit="page" from="181">181</biblScope>
<biblScope unit="page" to="184">184</biblScope>
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<front><div type="abstract" xml:lang="en">A therapeutic alternative to exenteration for large locally advanced vulvar carinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.</div>
</front>
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<PubMed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas.</title>
<author><name sortKey="Rotmensch, J" sort="Rotmensch, J" uniqKey="Rotmensch J" first="J" last="Rotmensch">J. Rotmensch</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea>Department of Obstetrics and Gynecology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Rubin, S J" sort="Rubin, S J" uniqKey="Rubin S" first="S J" last="Rubin">S J Rubin</name>
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<author><name sortKey="Sutton, H G" sort="Sutton, H G" uniqKey="Sutton H" first="H G" last="Sutton">H G Sutton</name>
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<author><name sortKey="Javaheri, G" sort="Javaheri, G" uniqKey="Javaheri G" first="G" last="Javaheri">G. Javaheri</name>
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<author><name sortKey="Halpern, H J" sort="Halpern, H J" uniqKey="Halpern H" first="H J" last="Halpern">H J Halpern</name>
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<author><name sortKey="Schwartz, J L" sort="Schwartz, J L" uniqKey="Schwartz J" first="J L" last="Schwartz">J L Schwartz</name>
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<author><name sortKey="Stewart, M" sort="Stewart, M" uniqKey="Stewart M" first="M" last="Stewart">M. Stewart</name>
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<author><name sortKey="Weichselbaum, R R" sort="Weichselbaum, R R" uniqKey="Weichselbaum R" first="R R" last="Weichselbaum">R R Weichselbaum</name>
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<author><name sortKey="Herbst, A L" sort="Herbst, A L" uniqKey="Herbst A" first="A L" last="Herbst">A L Herbst</name>
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<placeName><region type="state">Illinois</region>
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<wicri:cityArea>Department of Obstetrics and Gynecology, University of Chicago</wicri:cityArea>
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<author><name sortKey="Rubin, S J" sort="Rubin, S J" uniqKey="Rubin S" first="S J" last="Rubin">S J Rubin</name>
</author>
<author><name sortKey="Sutton, H G" sort="Sutton, H G" uniqKey="Sutton H" first="H G" last="Sutton">H G Sutton</name>
</author>
<author><name sortKey="Javaheri, G" sort="Javaheri, G" uniqKey="Javaheri G" first="G" last="Javaheri">G. Javaheri</name>
</author>
<author><name sortKey="Halpern, H J" sort="Halpern, H J" uniqKey="Halpern H" first="H J" last="Halpern">H J Halpern</name>
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<author><name sortKey="Schwartz, J L" sort="Schwartz, J L" uniqKey="Schwartz J" first="J L" last="Schwartz">J L Schwartz</name>
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<author><name sortKey="Stewart, M" sort="Stewart, M" uniqKey="Stewart M" first="M" last="Stewart">M. Stewart</name>
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<author><name sortKey="Herbst, A L" sort="Herbst, A L" uniqKey="Herbst A" first="A L" last="Herbst">A L Herbst</name>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Carcinoma, Squamous Cell (pathology)</term>
<term>Carcinoma, Squamous Cell (radiotherapy)</term>
<term>Carcinoma, Squamous Cell (surgery)</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Lymph Nodes (surgery)</term>
<term>Middle Aged</term>
<term>Preoperative Care</term>
<term>Radiation Injuries</term>
<term>Vulva (surgery)</term>
<term>Vulvar Neoplasms (pathology)</term>
<term>Vulvar Neoplasms (radiotherapy)</term>
<term>Vulvar Neoplasms (surgery)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Association thérapeutique</term>
<term>Carcinome épidermoïde ()</term>
<term>Carcinome épidermoïde (anatomopathologie)</term>
<term>Carcinome épidermoïde (radiothérapie)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lésions radio-induites</term>
<term>Noeuds lymphatiques ()</term>
<term>Soins préopératoires</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tumeurs de la vulve ()</term>
<term>Tumeurs de la vulve (anatomopathologie)</term>
<term>Tumeurs de la vulve (radiothérapie)</term>
<term>Vulve ()</term>
<term>Études de suivi</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinome épidermoïde</term>
<term>Tumeurs de la vulve</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Vulvar Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Vulvar Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Carcinome épidermoïde</term>
<term>Tumeurs de la vulve</term>
</keywords>
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<term>Lymph Nodes</term>
<term>Vulva</term>
<term>Vulvar Neoplasms</term>
</keywords>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Preoperative Care</term>
<term>Radiation Injuries</term>
</keywords>
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<term>Adulte d'âge moyen</term>
<term>Association thérapeutique</term>
<term>Carcinome épidermoïde</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lésions radio-induites</term>
<term>Noeuds lymphatiques</term>
<term>Soins préopératoires</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
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<term>Vulve</term>
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<front><div type="abstract" xml:lang="en">A therapeutic alternative to exenteration for large locally advanced vulvar carcinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.</div>
</front>
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