Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva
Identifieur interne : 002D46 ( Pmc/Checkpoint ); précédent : 002D45; suivant : 002D47Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva
Auteurs : Christopher P. Desimone [États-Unis] ; Jeffrey Elder [États-Unis] ; John R. Van Nagell [États-Unis]Source :
- International Journal of Surgical Oncology [ 2090-1402 ] ; 2011.
Abstract
En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injection of radiocolloid and blue dye may identify sentinel lymph nodes which can be removed, thereby avoiding the morbidity of full inguinal lymphadenectomy in selected patients with early stage disease.
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DOI: 10.1155/2011/284374
PubMed: 22312500
PubMed Central: 3263651
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva</title><author><name sortKey="Desimone, Christopher P" sort="Desimone, Christopher P" uniqKey="Desimone C" first="Christopher P." last="Desimone">Christopher P. Desimone</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293</wicri:regionArea><wicri:noRegion>KY 40536-0293</wicri:noRegion></affiliation></author><author><name sortKey="Elder, Jeffrey" sort="Elder, Jeffrey" uniqKey="Elder J" first="Jeffrey" last="Elder">Jeffrey Elder</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293</wicri:regionArea><wicri:noRegion>KY 40536-0293</wicri:noRegion></affiliation></author><author><name sortKey="Van Nagell, John R" sort="Van Nagell, John R" uniqKey="Van Nagell J" first="John R." last="Van Nagell">John R. Van Nagell</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293</wicri:regionArea><wicri:noRegion>KY 40536-0293</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22312500</idno><idno type="pmc">3263651</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263651</idno><idno type="RBID">PMC:3263651</idno><idno type="doi">10.1155/2011/284374</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">004A80</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004A80</idno><idno type="wicri:Area/Pmc/Curation">004A79</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004A79</idno><idno type="wicri:Area/Pmc/Checkpoint">002D46</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002D46</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva</title><author><name sortKey="Desimone, Christopher P" sort="Desimone, Christopher P" uniqKey="Desimone C" first="Christopher P." last="Desimone">Christopher P. Desimone</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293</wicri:regionArea><wicri:noRegion>KY 40536-0293</wicri:noRegion></affiliation></author><author><name sortKey="Elder, Jeffrey" sort="Elder, Jeffrey" uniqKey="Elder J" first="Jeffrey" last="Elder">Jeffrey Elder</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293</wicri:regionArea><wicri:noRegion>KY 40536-0293</wicri:noRegion></affiliation></author><author><name sortKey="Van Nagell, John R" sort="Van Nagell, John R" uniqKey="Van Nagell J" first="John R." last="Van Nagell">John R. Van Nagell</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293</wicri:regionArea><wicri:noRegion>KY 40536-0293</wicri:noRegion></affiliation></author></analytic><series><title level="j">International Journal of Surgical Oncology</title><idno type="ISSN">2090-1402</idno><idno type="eISSN">2090-1410</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injection of radiocolloid and blue dye may identify sentinel lymph nodes which can be removed, thereby avoiding the morbidity of full inguinal lymphadenectomy in selected patients with early stage disease.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Jemal, A" uniqKey="Jemal A">A Jemal</name></author><author><name sortKey="Siegel, R" uniqKey="Siegel R">R Siegel</name></author><author><name sortKey="Ward, E" uniqKey="Ward E">E Ward</name></author><author><name sortKey="Hao, Y" uniqKey="Hao Y">Y Hao</name></author><author><name sortKey="Xu, J" uniqKey="Xu J">J Xu</name></author><author><name sortKey="Thun, Mj" uniqKey="Thun M">MJ Thun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Plentl, Aa" uniqKey="Plentl A">AA Plentl</name></author><author><name sortKey="Friedman, Ea" uniqKey="Friedman E">EA 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Surg Oncol</journal-id><journal-id journal-id-type="iso-abbrev">Int J Surg Oncol</journal-id><journal-id journal-id-type="publisher-id">IJSO</journal-id><journal-title-group><journal-title>International Journal of Surgical Oncology</journal-title></journal-title-group><issn pub-type="ppub">2090-1402</issn><issn pub-type="epub">2090-1410</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22312500</article-id><article-id pub-id-type="pmc">3263651</article-id><article-id pub-id-type="doi">10.1155/2011/284374</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>DeSimone</surname><given-names>Christopher P.</given-names></name><xref ref-type="aff" rid="I1"></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Elder</surname><given-names>Jeffrey</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><name><surname>van Nagell</surname><given-names>John R.</given-names><suffix>Jr.</suffix></name><xref ref-type="aff" rid="I1"></xref></contrib></contrib-group><aff id="I1">Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Kentucky Chandler Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA</aff><author-notes><corresp id="cor1">*Christopher P. DeSimone: <email>cpdesi00@uky.edu</email></corresp><fn fn-type="other"><p>Academic Editor: E. W. Martin</p></fn></author-notes><pub-date pub-type="ppub"><year>2011</year></pub-date><pub-date pub-type="epub"><day>9</day><month>6</month><year>2011</year></pub-date><volume>2011</volume><elocation-id>284374</elocation-id><history><date date-type="received"><day>6</day><month>1</month><year>2011</year></date><date date-type="accepted"><day>5</day><month>4</month><year>2011</year></date></history><permissions><copyright-statement>Copyright © 2011 Christopher P. DeSimone et al.</copyright-statement><copyright-year>2011</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injection of radiocolloid and blue dye may identify sentinel lymph nodes which can be removed, thereby avoiding the morbidity of full inguinal lymphadenectomy in selected patients with early stage disease.</p></abstract></article-meta></front><floats-group><fig id="fig1" position="float"><label>Figure 1</label><caption><p>Lateral vulvar lesions >1 cm from the midline (a) spread initially to the ipsilateral superficial inguinal lymph nodes, whereas midline lesions can spread to both groins (b).</p></caption><graphic xlink:href="IJSO2011-284374.001"></graphic></fig><fig id="fig2" position="float"><label>Figure 2</label><caption><p>The Bassett-Way operation includes en bloc radical resection of the primary lesion and surrounding vulvar skin as well as the skin over both groins (a). Radical wide excision of the vulvar cancer includes a margin of at least 1 cm of normal skin around the entire lesion. Inguinal lymphadenectomy is performed through separate groin incisions (b).</p></caption><graphic xlink:href="IJSO2011-284374.002"></graphic></fig><fig id="fig3" position="float"><label>Figure 3</label><caption><p>Sentinel lymph node mapping. Sentinel lymph nodes are localized by perilesional injection of 99 mTc radiocolloid and isosulfan blue dye.</p></caption><graphic xlink:href="IJSO2011-284374.003"></graphic></fig><fig id="fig4" position="float"><label>Figure 4</label><caption><p>Radical wide excision and ipsilateral superficial inguinal lymphadenectomy is performed for lateral T<sub>1</sub> or T<sub>2</sub> vulvar cancers. All lymph nodes above the cribriform fascia are removed and the saphenous vein is preserved.</p></caption><graphic xlink:href="IJSO2011-284374.004"></graphic></fig><fig id="fig5" position="float"><label>Figure 5</label><caption><p>Radical wide excision and bilateral inguinofemoral lymphadenectomy is performed for midline vulvar cancers. This illustration depicts the right superficial inguinal lymph nodes and the left deep femoral lymph nodes which are seen along the medial aspect of the fossa ovalis.</p></caption><graphic xlink:href="IJSO2011-284374.005"></graphic></fig><table-wrap id="tab1" position="float"><label>Table 1</label><caption><p>FIGO staging of invasive cancer of the vulva.</p></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" rowspan="1" colspan="1">Stage I</td><td align="left" rowspan="1" colspan="1">Tumor confined to the vulva</td></tr><tr><td align="left" rowspan="1" colspan="1">IA</td><td align="left" rowspan="1" colspan="1">Lesions ≤2 cm in size confined to the vulva or perineum and with stromal invasion ≤1.0 mm*, no nodal metastasis</td></tr><tr><td align="left" rowspan="1" colspan="1">IB</td><td align="left" rowspan="1" colspan="1">Lesions >2 cm in size confined to the vulva or perineum with stromal invasion greater than 1.0 mm*, no nodal metastasis</td></tr><tr><td align="center" colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Stage II</td><td align="left" rowspan="1" colspan="1">Tumor of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus), no nodal metastasis</td></tr><tr><td align="center" colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Stage III</td><td align="left" rowspan="1" colspan="1">Tumor of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguinofemoral lymph nodes</td></tr><tr><td align="left" rowspan="1" colspan="1"> IIIA</td><td align="left" rowspan="1" colspan="1">With 1 lymph node metastasis (≥5 mm), </td></tr><tr><td align="left" rowspan="1" colspan="1"> IIIB</td><td align="left" rowspan="1" colspan="1">(i) With 2 or more lymph node metastases (≥5 mm), <break></break>(ii) 3 or more lymph node metastases (<5 mm)</td></tr><tr><td align="left" rowspan="1" colspan="1"> IIIC</td><td align="left" rowspan="1" colspan="1">With positive nodes with extracapsular spread</td></tr><tr><td align="center" colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Stage IV</td><td align="left" rowspan="1" colspan="1">Tumor invades other regional (2/3 upper urethra, 2/3 upper vagina) or distant structures</td></tr><tr><td align="left" rowspan="1" colspan="1"> IVA</td><td align="left" rowspan="1" colspan="1">Tumor invades any of the following:<break></break>(i) Upper urethra and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone,<break></break>(ii) Fixed or ulcerated inguinofemoral lymph nodes</td></tr><tr><td align="left" rowspan="1" colspan="1"> IVB</td><td align="left" rowspan="1" colspan="1">Any distant metastasis including pelvic lymph nodes</td></tr></tbody></table><table-wrap-foot><fn><p>*The depth of invasion is defined as the measurement of the tumor from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Desimone, Christopher P" sort="Desimone, Christopher P" uniqKey="Desimone C" first="Christopher P." last="Desimone">Christopher P. Desimone</name></noRegion><name sortKey="Elder, Jeffrey" sort="Elder, Jeffrey" uniqKey="Elder J" first="Jeffrey" last="Elder">Jeffrey Elder</name><name sortKey="Van Nagell, John R" sort="Van Nagell, John R" uniqKey="Van Nagell J" first="John R." last="Van Nagell">John R. Van Nagell</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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