A retrospective review of nodal treatment for vulvar cancer.
Identifieur interne : 005785 ( PubMed/Corpus ); précédent : 005784; suivant : 005786A retrospective review of nodal treatment for vulvar cancer.
Auteurs : D G Petereit ; M P Mehta ; D A Buchler ; T J KinsellaSource :
- American journal of clinical oncology [ 0277-3732 ] ; 1993.
English descriptors
- KwdEn :
- Aged, Carcinoma, Squamous Cell (pathology), Carcinoma, Squamous Cell (radiotherapy), Carcinoma, Squamous Cell (surgery), Female, Groin, Humans, Lymph Node Excision, Lymphatic Irradiation, Lymphatic Metastasis (prevention & control), Neoplasm Invasiveness, Retrospective Studies, Survival Analysis, Vulvar Neoplasms (pathology), Vulvar Neoplasms (radiotherapy), Vulvar Neoplasms (surgery).
- MESH :
- pathology : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- prevention & control : Lymphatic Metastasis.
- radiotherapy : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- surgery : Carcinoma, Squamous Cell, Vulvar Neoplasms.
- Aged, Female, Groin, Humans, Lymph Node Excision, Lymphatic Irradiation, Neoplasm Invasiveness, Retrospective Studies, Survival Analysis.
Abstract
From 1983 to 1990, 42 clinical N0, N1 patients with invasive squamous cell carcinoma of the vulva underwent surgery for the primary cancer, followed by nonrandomized assignment to either surgery or radiation therapy for nodal management. This is a retrospective analysis reviewing treatment outcome and complications of inguinofemoral dissection versus photon irradiation. Group I (N = 24) underwent either bilateral or unilateral inguinofemoral dissection; Group II (N = 18) underwent bilateral groin irradiation. The 3-year disease-free survival was 84.5% and 79.7% for Group I and II (p = 0.74). The nodal failure rate at 3 years was not significantly different. The postoperative complications in the surgically treated nodes were: 17% seromas, 46% wound infection, and 71% wound separation. Of those patients developing either an infection or wound separation, 41% required daily wound care for more than 2 weeks by a visiting nurse after discharge. Only 1 of 18 (6%) irradiated patients developed a clinically significant skin reaction. The median time for complete skin/wound healing was 8 weeks (range 4-24 weeks) in Group I and 2 weeks (range 2-6 weeks) in Group II. Late postoperative complications in the surgically treated patients included meralgia paresthetica (8%) and lymphedema (12%); 1 (6%) Group II patient developed lymphedema. Based on this limited retrospective review, we conclude that inguinofemoral radiation achieves reasonable local control and may represent an alternative to surgery in selected patients. The acute and delayed morbidity of lymphadenectomy exceeds that of irradiation.
PubMed: 8424402
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pubmed:8424402Le document en format XML
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<author><name sortKey="Petereit, D G" sort="Petereit, D G" uniqKey="Petereit D" first="D G" last="Petereit">D G Petereit</name>
<affiliation><nlm:affiliation>Department of Human Oncology, University of Wisconsin Clinical Cancer Center, Madison 53792.</nlm:affiliation>
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<author><name sortKey="Mehta, M P" sort="Mehta, M P" uniqKey="Mehta M" first="M P" last="Mehta">M P Mehta</name>
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<author><name sortKey="Buchler, D A" sort="Buchler, D A" uniqKey="Buchler D" first="D A" last="Buchler">D A Buchler</name>
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<author><name sortKey="Kinsella, T J" sort="Kinsella, T J" uniqKey="Kinsella T" first="T J" last="Kinsella">T J Kinsella</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">A retrospective review of nodal treatment for vulvar cancer.</title>
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<author><name sortKey="Buchler, D A" sort="Buchler, D A" uniqKey="Buchler D" first="D A" last="Buchler">D A Buchler</name>
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<term>Carcinoma, Squamous Cell (pathology)</term>
<term>Carcinoma, Squamous Cell (radiotherapy)</term>
<term>Carcinoma, Squamous Cell (surgery)</term>
<term>Female</term>
<term>Groin</term>
<term>Humans</term>
<term>Lymph Node Excision</term>
<term>Lymphatic Irradiation</term>
<term>Lymphatic Metastasis (prevention & control)</term>
<term>Neoplasm Invasiveness</term>
<term>Retrospective Studies</term>
<term>Survival Analysis</term>
<term>Vulvar Neoplasms (pathology)</term>
<term>Vulvar Neoplasms (radiotherapy)</term>
<term>Vulvar Neoplasms (surgery)</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Vulvar Neoplasms</term>
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<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Lymphatic Metastasis</term>
</keywords>
<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="surgery" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Vulvar Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Groin</term>
<term>Humans</term>
<term>Lymph Node Excision</term>
<term>Lymphatic Irradiation</term>
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<front><div type="abstract" xml:lang="en">From 1983 to 1990, 42 clinical N0, N1 patients with invasive squamous cell carcinoma of the vulva underwent surgery for the primary cancer, followed by nonrandomized assignment to either surgery or radiation therapy for nodal management. This is a retrospective analysis reviewing treatment outcome and complications of inguinofemoral dissection versus photon irradiation. Group I (N = 24) underwent either bilateral or unilateral inguinofemoral dissection; Group II (N = 18) underwent bilateral groin irradiation. The 3-year disease-free survival was 84.5% and 79.7% for Group I and II (p = 0.74). The nodal failure rate at 3 years was not significantly different. The postoperative complications in the surgically treated nodes were: 17% seromas, 46% wound infection, and 71% wound separation. Of those patients developing either an infection or wound separation, 41% required daily wound care for more than 2 weeks by a visiting nurse after discharge. Only 1 of 18 (6%) irradiated patients developed a clinically significant skin reaction. The median time for complete skin/wound healing was 8 weeks (range 4-24 weeks) in Group I and 2 weeks (range 2-6 weeks) in Group II. Late postoperative complications in the surgically treated patients included meralgia paresthetica (8%) and lymphedema (12%); 1 (6%) Group II patient developed lymphedema. Based on this limited retrospective review, we conclude that inguinofemoral radiation achieves reasonable local control and may represent an alternative to surgery in selected patients. The acute and delayed morbidity of lymphadenectomy exceeds that of irradiation.</div>
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<DateCompleted><Year>1993</Year>
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<Title>American journal of clinical oncology</Title>
<ISOAbbreviation>Am. J. Clin. Oncol.</ISOAbbreviation>
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<ArticleTitle>A retrospective review of nodal treatment for vulvar cancer.</ArticleTitle>
<Pagination><MedlinePgn>38-42</MedlinePgn>
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<Abstract><AbstractText>From 1983 to 1990, 42 clinical N0, N1 patients with invasive squamous cell carcinoma of the vulva underwent surgery for the primary cancer, followed by nonrandomized assignment to either surgery or radiation therapy for nodal management. This is a retrospective analysis reviewing treatment outcome and complications of inguinofemoral dissection versus photon irradiation. Group I (N = 24) underwent either bilateral or unilateral inguinofemoral dissection; Group II (N = 18) underwent bilateral groin irradiation. The 3-year disease-free survival was 84.5% and 79.7% for Group I and II (p = 0.74). The nodal failure rate at 3 years was not significantly different. The postoperative complications in the surgically treated nodes were: 17% seromas, 46% wound infection, and 71% wound separation. Of those patients developing either an infection or wound separation, 41% required daily wound care for more than 2 weeks by a visiting nurse after discharge. Only 1 of 18 (6%) irradiated patients developed a clinically significant skin reaction. The median time for complete skin/wound healing was 8 weeks (range 4-24 weeks) in Group I and 2 weeks (range 2-6 weeks) in Group II. Late postoperative complications in the surgically treated patients included meralgia paresthetica (8%) and lymphedema (12%); 1 (6%) Group II patient developed lymphedema. Based on this limited retrospective review, we conclude that inguinofemoral radiation achieves reasonable local control and may represent an alternative to surgery in selected patients. The acute and delayed morbidity of lymphadenectomy exceeds that of irradiation.</AbstractText>
</Abstract>
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<MeshHeading><DescriptorName UI="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName>
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<MeshHeading><DescriptorName UI="D014846" MajorTopicYN="N">Vulvar Neoplasms</DescriptorName>
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