Invasive squamous cell carcinoma of the vulva: behaviour and results in the light of changing management regimens. A review of clinicohistological features predictive of regional lymph node involvement and local recurrence.
Identifieur interne : 001A33 ( Ncbi/Checkpoint ); précédent : 001A32; suivant : 001A34Invasive squamous cell carcinoma of the vulva: behaviour and results in the light of changing management regimens. A review of clinicohistological features predictive of regional lymph node involvement and local recurrence.
Auteurs : D. Lingard [Australie] ; K. Free ; R G Wright ; D. BattistuttaSource :
- The Australian & New Zealand journal of obstetrics & gynaecology [ 0004-8666 ] ; 1992.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Analyse de survie, Analyse multivariée, Carcinome épidermoïde (), Carcinome épidermoïde (anatomopathologie), Carcinome épidermoïde (mortalité), Complications postopératoires (épidémiologie), Femelle, Humains, Invasion tumorale, Lymphadénectomie, Métastase lymphatique, Pronostic, Récidive tumorale locale (épidémiologie), Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Taux de survie, Tumeurs de la vulve (), Tumeurs de la vulve (anatomopathologie), Tumeurs de la vulve (mortalité), Études de suivi, Études rétrospectives.
- MESH :
- anatomopathologie : Carcinome épidermoïde, Tumeurs de la vulve.
- mortalité : Carcinome épidermoïde, Tumeurs de la vulve.
- épidémiologie : Complications postopératoires, Récidive tumorale locale.
- Adulte, Adulte d'âge moyen, Analyse de survie, Analyse multivariée, Carcinome épidermoïde, Femelle, Humains, Invasion tumorale, Lymphadénectomie, Métastase lymphatique, Pronostic, Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Taux de survie, Tumeurs de la vulve, Études de suivi, Études rétrospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell (mortality), Carcinoma, Squamous Cell (pathology), Carcinoma, Squamous Cell (therapy), Female, Follow-Up Studies, Humans, Lymph Node Excision, Lymphatic Metastasis, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness, Neoplasm Recurrence, Local (epidemiology), Neoplasm Staging, Postoperative Complications (epidemiology), Prognosis, Retrospective Studies, Survival Analysis, Survival Rate, Vulvar Neoplasms (mortality), Vulvar Neoplasms (pathology), Vulvar Neoplasms (therapy).
- MESH :
- epidemiology : Neoplasm Recurrence, Local, Postoperative Complications.
- mortality : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- pathology : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- therapy : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Lymph Node Excision, Lymphatic Metastasis, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Analysis, Survival Rate.
Abstract
Ninety-nine patients with carcinoma of the vulva were referred to the Gynaecologic Oncology Unit, Royal Brisbane Hospital, over 10 years. Ninety of these patients had a squamous cell carcinoma (SCC). They were assessed by the 1969 FIGO clinical staging. Each stage was related to nodal involvement, size, depth, histological grade, lymphvascular space involvement, perineural permeation and multifocal disease site. The operability rate was 85%. Treatment was individualized in line with recent philosophies for more conservative surgery where appropriate. Mortality was 2.6%. Five-year survival of surgically treated patients was 60.3%; node negative patients 100%, and node positive patients 25.2%. After adjustment for stage and size, the only other independent statistically significant feature was perineural penetration. Local recurrence was more likely with increased stage and size, unclear margins and multifocal involvement. It is important to note that medically unfit patients who had vulvectomy alone and who later developed positive nodes had 100% mortality. This group of patients significantly decreases survival rates, confirming the importance of carrying out inguinofemoral lymphadenectomy at the time of initial surgery. Morbidity was decreased by conservative surgery. Lymphoedema remains the most common chronic complication. No significant difference was shown in local recurrence between different types of surgery, wide excision, hemivulvectomy, simple vulvectomy or radical vulvectomy (22%), confirming the safety of the more conservative approach of recent years.
PubMed: 1520199
Affiliations:
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Free</name></author><author><name sortKey="Wright, R G" sort="Wright, R G" uniqKey="Wright R" first="R G" last="Wright">R G Wright</name></author><author><name sortKey="Battistutta, D" sort="Battistutta, D" uniqKey="Battistutta D" first="D" last="Battistutta">D. 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A review of clinicohistological features predictive of regional lymph node involvement and local recurrence.</title><author><name sortKey="Lingard, D" sort="Lingard, D" uniqKey="Lingard D" first="D" last="Lingard">D. Lingard</name><affiliation wicri:level="2"><nlm:affiliation>Department of Gynaecologic Oncology, Royal Brisbane Hospital, Queensland.</nlm:affiliation><country>Australie</country><placeName><region type="state">Queensland</region></placeName><wicri:cityArea>Department of Gynaecologic Oncology, Royal Brisbane Hospital</wicri:cityArea></affiliation></author><author><name sortKey="Free, K" sort="Free, K" uniqKey="Free K" first="K" last="Free">K. Free</name></author><author><name sortKey="Wright, R G" sort="Wright, R G" uniqKey="Wright R" first="R G" last="Wright">R G Wright</name></author><author><name sortKey="Battistutta, D" sort="Battistutta, D" uniqKey="Battistutta D" first="D" last="Battistutta">D. Battistutta</name></author></analytic><series><title level="j">The Australian & New Zealand journal of obstetrics & gynaecology</title><idno type="ISSN">0004-8666</idno><imprint><date when="1992" type="published">1992</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Carcinoma, Squamous Cell (mortality)</term><term>Carcinoma, Squamous Cell (pathology)</term><term>Carcinoma, Squamous Cell (therapy)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision</term><term>Lymphatic Metastasis</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Neoplasm Invasiveness</term><term>Neoplasm Recurrence, Local (epidemiology)</term><term>Neoplasm Staging</term><term>Postoperative Complications (epidemiology)</term><term>Prognosis</term><term>Retrospective Studies</term><term>Survival Analysis</term><term>Survival Rate</term><term>Vulvar Neoplasms (mortality)</term><term>Vulvar Neoplasms (pathology)</term><term>Vulvar Neoplasms (therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Analyse multivariée</term><term>Carcinome épidermoïde ()</term><term>Carcinome épidermoïde (anatomopathologie)</term><term>Carcinome épidermoïde (mortalité)</term><term>Complications postopératoires (épidémiologie)</term><term>Femelle</term><term>Humains</term><term>Invasion tumorale</term><term>Lymphadénectomie</term><term>Métastase lymphatique</term><term>Pronostic</term><term>Récidive tumorale locale (épidémiologie)</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Taux de survie</term><term>Tumeurs de la vulve ()</term><term>Tumeurs de la vulve (anatomopathologie)</term><term>Tumeurs de la vulve (mortalité)</term><term>Études de suivi</term><term>Études rétrospectives</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="epidemiology" xml:lang="en"><term>Neoplasm Recurrence, Local</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Vulvar Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortalité" 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="therapy" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Vulvar Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications postopératoires</term><term>Récidive tumorale locale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision</term><term>Lymphatic Metastasis</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Neoplasm Invasiveness</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Retrospective Studies</term><term>Survival Analysis</term><term>Survival Rate</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Analyse multivariée</term><term>Carcinome épidermoïde</term><term>Femelle</term><term>Humains</term><term>Invasion tumorale</term><term>Lymphadénectomie</term><term>Métastase lymphatique</term><term>Pronostic</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Taux de survie</term><term>Tumeurs de la vulve</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Ninety-nine patients with carcinoma of the vulva were referred to the Gynaecologic Oncology Unit, Royal Brisbane Hospital, over 10 years. Ninety of these patients had a squamous cell carcinoma (SCC). They were assessed by the 1969 FIGO clinical staging. Each stage was related to nodal involvement, size, depth, histological grade, lymphvascular space involvement, perineural permeation and multifocal disease site. The operability rate was 85%. Treatment was individualized in line with recent philosophies for more conservative surgery where appropriate. Mortality was 2.6%. Five-year survival of surgically treated patients was 60.3%; node negative patients 100%, and node positive patients 25.2%. After adjustment for stage and size, the only other independent statistically significant feature was perineural penetration. Local recurrence was more likely with increased stage and size, unclear margins and multifocal involvement. It is important to note that medically unfit patients who had vulvectomy alone and who later developed positive nodes had 100% mortality. This group of patients significantly decreases survival rates, confirming the importance of carrying out inguinofemoral lymphadenectomy at the time of initial surgery. Morbidity was decreased by conservative surgery. Lymphoedema remains the most common chronic complication. No significant difference was shown in local recurrence between different types of surgery, wide excision, hemivulvectomy, simple vulvectomy or radical vulvectomy (22%), confirming the safety of the more conservative approach of recent years.</div></front></TEI><affiliations><list><country><li>Australie</li></country><region><li>Queensland</li></region></list><tree><noCountry><name sortKey="Battistutta, D" sort="Battistutta, D" uniqKey="Battistutta D" first="D" last="Battistutta">D. Battistutta</name><name sortKey="Free, K" sort="Free, K" uniqKey="Free K" first="K" last="Free">K. Free</name><name sortKey="Wright, R G" sort="Wright, R G" uniqKey="Wright R" first="R G" last="Wright">R G Wright</name></noCountry><country name="Australie"><region name="Queensland"><name sortKey="Lingard, D" sort="Lingard, D" uniqKey="Lingard D" first="D" last="Lingard">D. Lingard</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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