Vulvar cancer: surgical management and survival trends in a low resource setting
Background This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May...
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| Veröffentlicht in: | Journal of Egyptian National Cancer Institute 2020-01, Vol.32 (1), p.4-7, Article 4 |
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| creator | Kumar, Navin Ray, Mukur Dipi Sharma, D. N. Pandey, Rambha Lata, Kanak Mishra, Ashutosh Wankhede, Durgesh Saikia, Jyoutishman |
| description | Background
This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May 2014 to June 2019.
Results
The mean age of VC diagnosis was 55 years, with a range of 38–84 years. The incidence was four cases per year. The disease incidence was significantly more in post-menopausal (65%) and multiparous (90%) women. According to FIGO staging of vulvar cancer, stages I, II, and III were assigned to 6, 1, and 11 patients respectively. Two patients suffered from stage IVa vulvar melanoma. All patients had undergone surgical interventions. Patients treated with only nonsurgical (chemotherapy/radiotherapy/chemo-radiotherapy) treatment modalities were excluded from the study. Fifteen patients were treated with wide local excision (WLE), bilateral inguinofemoral dissection (B/L IFLND), and primary repair. Four and one patients were treated with radical vulvectomy (RV) and modified radical vulvectomy (MRV) [with or without B/L IFLND and PLND] respectively. Reconstruction with V-Y gracilis myocutaneous and local rotation advancement V-Y fasciocutaneous flaps were done in two patients. Therapeutic groin nodal dissection was performed in 19 patients except in one patient who was treated by palliative radical vulvectomy. In the final histopathology reports, tumor size varies from 0.5 to 6.5 cm (mean 3.35 cm) with the predominance of squamous cell carcinoma (18 out of 20 patients). Only 10 out of 18 eligible patients received adjuvant treatment. Poor patient compliance has been one of the major reasons for adjuvant treatment attrition rate. Systemic and loco-regional metastasis occurred in 3 patients each arm respectively. Poor follow up of patients is the key limitation of our study.
Conclusion
Vulvar cancer incidence was significantly high in post-menopausal and multiparous women. The most important prognostic factors were tumor stage and lymph node status. Oncological resection should be equated with functional outcome. The multidisciplinary team approach should be sought for this rare gynecological malignancy. |
| doi_str_mv | 10.1186/s43046-019-0015-y |
| format | Article |
| fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_proquest_journals_2729536074</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A680085080</galeid><doaj_id>oai_doaj_org_article_881051976e154b899f9aab377103ed9b</doaj_id><sourcerecordid>A680085080</sourcerecordid><originalsourceid>FETCH-LOGICAL-c548t-117deb0df513772ae85b6190f67f7be8b4828d69441d7c493b0f844a157531b43</originalsourceid><addsrcrecordid>eNp1UcmO1TAQjBCIWeADuKBInDO0Yzu2uY1GLCONBAfgannpRH5KnMFOHnp_jx-ZBSSQD3aXq8rdrqp6ReCCENm9zYwC6xogqgEgvDk8qU5bLkvFQD3943xSneW8A-g6EPx5dUJbKtpW0tPqy_d13JtUOxMdpnd1XtMQnBnryUQz4IRxqU30R3wf9gVfEkaf6xBrU4_zzzphntfksM64LCEOL6pnvRkzvrzbz6tvH95_vfrU3Hz-eH11edM4zuTSECI8WvA9J1SI1qDktiMK-k70wqK0TLbSd4ox4oVjilroJWOGcMEpsYyeV9ebr5_NTt-mMJl00LMJ-jcwp0GbtAQ3opaSACdKdEg4s1KpXhljy7MEKHpli9ebzes2zT9WzIvelZliaV-3olWclm9jj6zBFNMQ-3lJxk0hO33ZSQDJQUJhXfyDVZbHKbg5Yh8K_peAbAKX5pwT9g_DENDHmPUWsy4x62PM-lA0r-8aXu2E_kFxn2shtBshl6s4YHqc6P-uvwCisK-r</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2729536074</pqid></control><display><type>article</type><title>Vulvar cancer: surgical management and survival trends in a low resource setting</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Springer Nature OA Free Journals</source><creator>Kumar, Navin ; Ray, Mukur Dipi ; Sharma, D. N. ; Pandey, Rambha ; Lata, Kanak ; Mishra, Ashutosh ; Wankhede, Durgesh ; Saikia, Jyoutishman</creator><creatorcontrib>Kumar, Navin ; Ray, Mukur Dipi ; Sharma, D. N. ; Pandey, Rambha ; Lata, Kanak ; Mishra, Ashutosh ; Wankhede, Durgesh ; Saikia, Jyoutishman</creatorcontrib><description>Background
This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May 2014 to June 2019.
Results
The mean age of VC diagnosis was 55 years, with a range of 38–84 years. The incidence was four cases per year. The disease incidence was significantly more in post-menopausal (65%) and multiparous (90%) women. According to FIGO staging of vulvar cancer, stages I, II, and III were assigned to 6, 1, and 11 patients respectively. Two patients suffered from stage IVa vulvar melanoma. All patients had undergone surgical interventions. Patients treated with only nonsurgical (chemotherapy/radiotherapy/chemo-radiotherapy) treatment modalities were excluded from the study. Fifteen patients were treated with wide local excision (WLE), bilateral inguinofemoral dissection (B/L IFLND), and primary repair. Four and one patients were treated with radical vulvectomy (RV) and modified radical vulvectomy (MRV) [with or without B/L IFLND and PLND] respectively. Reconstruction with V-Y gracilis myocutaneous and local rotation advancement V-Y fasciocutaneous flaps were done in two patients. Therapeutic groin nodal dissection was performed in 19 patients except in one patient who was treated by palliative radical vulvectomy. In the final histopathology reports, tumor size varies from 0.5 to 6.5 cm (mean 3.35 cm) with the predominance of squamous cell carcinoma (18 out of 20 patients). Only 10 out of 18 eligible patients received adjuvant treatment. Poor patient compliance has been one of the major reasons for adjuvant treatment attrition rate. Systemic and loco-regional metastasis occurred in 3 patients each arm respectively. Poor follow up of patients is the key limitation of our study.
Conclusion
Vulvar cancer incidence was significantly high in post-menopausal and multiparous women. The most important prognostic factors were tumor stage and lymph node status. Oncological resection should be equated with functional outcome. The multidisciplinary team approach should be sought for this rare gynecological malignancy.</description><identifier>ISSN: 2589-0409</identifier><identifier>ISSN: 1110-0362</identifier><identifier>EISSN: 2589-0409</identifier><identifier>DOI: 10.1186/s43046-019-0015-y</identifier><identifier>PMID: 32372283</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cancer patients ; Cancer therapies ; Carcinoma, Squamous Cell - diagnosis ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - therapy ; Care and treatment ; Cellulitis ; Chemoradiotherapy, Adjuvant - statistics & numerical data ; Comorbidity ; Disease-Free Survival ; Dissection ; Female ; Genital cancers ; Gynecology ; Health aspects ; Histochemistry ; Histology ; Histopathology ; Humans ; Incidence ; Inguinofemoral node dissection ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymphatic Metastasis ; Lymphatic system ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Melanoma ; Menopause ; Middle Aged ; Modified radical vulvectomy ; Multi-disciplinary tumor board ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - prevention & control ; Neoplasm Staging ; Obstetrics ; Oncology ; Palliative care ; Patient compliance ; Patient Compliance - statistics & numerical data ; Patients ; Postmenopausal women ; Postoperative period ; Prospective Studies ; Radiation therapy ; Radiotherapy ; Reconstructive Surgical Procedures - methods ; Retrospective Studies ; Risk Factors ; Skin cancer ; Squamous cell carcinoma ; Statistical analysis ; Stream flow ; Surgery ; Surgical Flaps - transplantation ; Survival ; Sutures ; Tomography ; Trends ; Tumor staging ; Vagina ; Venture capital ; Vulva - pathology ; Vulva - surgery ; Vulvar cancer ; Vulvar Neoplasms - diagnosis ; Vulvar Neoplasms - mortality ; Vulvar Neoplasms - pathology ; Vulvar Neoplasms - therapy ; Vulvectomy - adverse effects ; Vulvectomy - methods ; Womens health ; Wound dehiscence</subject><ispartof>Journal of Egyptian National Cancer Institute, 2020-01, Vol.32 (1), p.4-7, Article 4</ispartof><rights>The Author(s) 2020</rights><rights>COPYRIGHT 2020 Springer</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c548t-117deb0df513772ae85b6190f67f7be8b4828d69441d7c493b0f844a157531b43</citedby><cites>FETCH-LOGICAL-c548t-117deb0df513772ae85b6190f67f7be8b4828d69441d7c493b0f844a157531b43</cites><orcidid>0000-0002-4059-8153</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,865,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32372283$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Navin</creatorcontrib><creatorcontrib>Ray, Mukur Dipi</creatorcontrib><creatorcontrib>Sharma, D. N.</creatorcontrib><creatorcontrib>Pandey, Rambha</creatorcontrib><creatorcontrib>Lata, Kanak</creatorcontrib><creatorcontrib>Mishra, Ashutosh</creatorcontrib><creatorcontrib>Wankhede, Durgesh</creatorcontrib><creatorcontrib>Saikia, Jyoutishman</creatorcontrib><title>Vulvar cancer: surgical management and survival trends in a low resource setting</title><title>Journal of Egyptian National Cancer Institute</title><addtitle>J Egypt Natl Canc Inst</addtitle><addtitle>J Egypt Natl Canc Inst</addtitle><description>Background
This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May 2014 to June 2019.
Results
The mean age of VC diagnosis was 55 years, with a range of 38–84 years. The incidence was four cases per year. The disease incidence was significantly more in post-menopausal (65%) and multiparous (90%) women. According to FIGO staging of vulvar cancer, stages I, II, and III were assigned to 6, 1, and 11 patients respectively. Two patients suffered from stage IVa vulvar melanoma. All patients had undergone surgical interventions. Patients treated with only nonsurgical (chemotherapy/radiotherapy/chemo-radiotherapy) treatment modalities were excluded from the study. Fifteen patients were treated with wide local excision (WLE), bilateral inguinofemoral dissection (B/L IFLND), and primary repair. Four and one patients were treated with radical vulvectomy (RV) and modified radical vulvectomy (MRV) [with or without B/L IFLND and PLND] respectively. Reconstruction with V-Y gracilis myocutaneous and local rotation advancement V-Y fasciocutaneous flaps were done in two patients. Therapeutic groin nodal dissection was performed in 19 patients except in one patient who was treated by palliative radical vulvectomy. In the final histopathology reports, tumor size varies from 0.5 to 6.5 cm (mean 3.35 cm) with the predominance of squamous cell carcinoma (18 out of 20 patients). Only 10 out of 18 eligible patients received adjuvant treatment. Poor patient compliance has been one of the major reasons for adjuvant treatment attrition rate. Systemic and loco-regional metastasis occurred in 3 patients each arm respectively. Poor follow up of patients is the key limitation of our study.
Conclusion
Vulvar cancer incidence was significantly high in post-menopausal and multiparous women. The most important prognostic factors were tumor stage and lymph node status. Oncological resection should be equated with functional outcome. The multidisciplinary team approach should be sought for this rare gynecological malignancy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer patients</subject><subject>Cancer therapies</subject><subject>Carcinoma, Squamous Cell - diagnosis</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Care and treatment</subject><subject>Cellulitis</subject><subject>Chemoradiotherapy, Adjuvant - statistics & numerical data</subject><subject>Comorbidity</subject><subject>Disease-Free Survival</subject><subject>Dissection</subject><subject>Female</subject><subject>Genital cancers</subject><subject>Gynecology</subject><subject>Health aspects</subject><subject>Histochemistry</subject><subject>Histology</subject><subject>Histopathology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Inguinofemoral node dissection</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymph Node Excision</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Melanoma</subject><subject>Menopause</subject><subject>Middle Aged</subject><subject>Modified radical vulvectomy</subject><subject>Multi-disciplinary tumor board</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - prevention & control</subject><subject>Neoplasm Staging</subject><subject>Obstetrics</subject><subject>Oncology</subject><subject>Palliative care</subject><subject>Patient compliance</subject><subject>Patient Compliance - statistics & numerical data</subject><subject>Patients</subject><subject>Postmenopausal women</subject><subject>Postoperative period</subject><subject>Prospective Studies</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Skin cancer</subject><subject>Squamous cell carcinoma</subject><subject>Statistical analysis</subject><subject>Stream flow</subject><subject>Surgery</subject><subject>Surgical Flaps - transplantation</subject><subject>Survival</subject><subject>Sutures</subject><subject>Tomography</subject><subject>Trends</subject><subject>Tumor staging</subject><subject>Vagina</subject><subject>Venture capital</subject><subject>Vulva - pathology</subject><subject>Vulva - surgery</subject><subject>Vulvar cancer</subject><subject>Vulvar Neoplasms - diagnosis</subject><subject>Vulvar Neoplasms - mortality</subject><subject>Vulvar Neoplasms - pathology</subject><subject>Vulvar Neoplasms - therapy</subject><subject>Vulvectomy - adverse effects</subject><subject>Vulvectomy - methods</subject><subject>Womens health</subject><subject>Wound dehiscence</subject><issn>2589-0409</issn><issn>1110-0362</issn><issn>2589-0409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNp1UcmO1TAQjBCIWeADuKBInDO0Yzu2uY1GLCONBAfgannpRH5KnMFOHnp_jx-ZBSSQD3aXq8rdrqp6ReCCENm9zYwC6xogqgEgvDk8qU5bLkvFQD3943xSneW8A-g6EPx5dUJbKtpW0tPqy_d13JtUOxMdpnd1XtMQnBnryUQz4IRxqU30R3wf9gVfEkaf6xBrU4_zzzphntfksM64LCEOL6pnvRkzvrzbz6tvH95_vfrU3Hz-eH11edM4zuTSECI8WvA9J1SI1qDktiMK-k70wqK0TLbSd4ox4oVjilroJWOGcMEpsYyeV9ebr5_NTt-mMJl00LMJ-jcwp0GbtAQ3opaSACdKdEg4s1KpXhljy7MEKHpli9ebzes2zT9WzIvelZliaV-3olWclm9jj6zBFNMQ-3lJxk0hO33ZSQDJQUJhXfyDVZbHKbg5Yh8K_peAbAKX5pwT9g_DENDHmPUWsy4x62PM-lA0r-8aXu2E_kFxn2shtBshl6s4YHqc6P-uvwCisK-r</recordid><startdate>20200114</startdate><enddate>20200114</enddate><creator>Kumar, Navin</creator><creator>Ray, Mukur Dipi</creator><creator>Sharma, D. N.</creator><creator>Pandey, Rambha</creator><creator>Lata, Kanak</creator><creator>Mishra, Ashutosh</creator><creator>Wankhede, Durgesh</creator><creator>Saikia, Jyoutishman</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><general>SpringerOpen</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4059-8153</orcidid></search><sort><creationdate>20200114</creationdate><title>Vulvar cancer: surgical management and survival trends in a low resource setting</title><author>Kumar, Navin ; Ray, Mukur Dipi ; Sharma, D. N. ; Pandey, Rambha ; Lata, Kanak ; Mishra, Ashutosh ; Wankhede, Durgesh ; Saikia, Jyoutishman</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c548t-117deb0df513772ae85b6190f67f7be8b4828d69441d7c493b0f844a157531b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer patients</topic><topic>Cancer therapies</topic><topic>Carcinoma, Squamous Cell - diagnosis</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Care and treatment</topic><topic>Cellulitis</topic><topic>Chemoradiotherapy, Adjuvant - statistics & numerical data</topic><topic>Comorbidity</topic><topic>Disease-Free Survival</topic><topic>Dissection</topic><topic>Female</topic><topic>Genital cancers</topic><topic>Gynecology</topic><topic>Health aspects</topic><topic>Histochemistry</topic><topic>Histology</topic><topic>Histopathology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Inguinofemoral node dissection</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymph Node Excision</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Melanoma</topic><topic>Menopause</topic><topic>Middle Aged</topic><topic>Modified radical vulvectomy</topic><topic>Multi-disciplinary tumor board</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - prevention & control</topic><topic>Neoplasm Staging</topic><topic>Obstetrics</topic><topic>Oncology</topic><topic>Palliative care</topic><topic>Patient compliance</topic><topic>Patient Compliance - statistics & numerical data</topic><topic>Patients</topic><topic>Postmenopausal women</topic><topic>Postoperative period</topic><topic>Prospective Studies</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Skin cancer</topic><topic>Squamous cell carcinoma</topic><topic>Statistical analysis</topic><topic>Stream flow</topic><topic>Surgery</topic><topic>Surgical Flaps - transplantation</topic><topic>Survival</topic><topic>Sutures</topic><topic>Tomography</topic><topic>Trends</topic><topic>Tumor staging</topic><topic>Vagina</topic><topic>Venture capital</topic><topic>Vulva - pathology</topic><topic>Vulva - surgery</topic><topic>Vulvar cancer</topic><topic>Vulvar Neoplasms - diagnosis</topic><topic>Vulvar Neoplasms - mortality</topic><topic>Vulvar Neoplasms - pathology</topic><topic>Vulvar Neoplasms - therapy</topic><topic>Vulvectomy - adverse effects</topic><topic>Vulvectomy - methods</topic><topic>Womens health</topic><topic>Wound dehiscence</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Navin</creatorcontrib><creatorcontrib>Ray, Mukur Dipi</creatorcontrib><creatorcontrib>Sharma, D. N.</creatorcontrib><creatorcontrib>Pandey, Rambha</creatorcontrib><creatorcontrib>Lata, Kanak</creatorcontrib><creatorcontrib>Mishra, Ashutosh</creatorcontrib><creatorcontrib>Wankhede, Durgesh</creatorcontrib><creatorcontrib>Saikia, Jyoutishman</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of Egyptian National Cancer Institute</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Navin</au><au>Ray, Mukur Dipi</au><au>Sharma, D. N.</au><au>Pandey, Rambha</au><au>Lata, Kanak</au><au>Mishra, Ashutosh</au><au>Wankhede, Durgesh</au><au>Saikia, Jyoutishman</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vulvar cancer: surgical management and survival trends in a low resource setting</atitle><jtitle>Journal of Egyptian National Cancer Institute</jtitle><stitle>J Egypt Natl Canc Inst</stitle><addtitle>J Egypt Natl Canc Inst</addtitle><date>2020-01-14</date><risdate>2020</risdate><volume>32</volume><issue>1</issue><spage>4</spage><epage>7</epage><pages>4-7</pages><artnum>4</artnum><issn>2589-0409</issn><issn>1110-0362</issn><eissn>2589-0409</eissn><abstract>Background
This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May 2014 to June 2019.
Results
The mean age of VC diagnosis was 55 years, with a range of 38–84 years. The incidence was four cases per year. The disease incidence was significantly more in post-menopausal (65%) and multiparous (90%) women. According to FIGO staging of vulvar cancer, stages I, II, and III were assigned to 6, 1, and 11 patients respectively. Two patients suffered from stage IVa vulvar melanoma. All patients had undergone surgical interventions. Patients treated with only nonsurgical (chemotherapy/radiotherapy/chemo-radiotherapy) treatment modalities were excluded from the study. Fifteen patients were treated with wide local excision (WLE), bilateral inguinofemoral dissection (B/L IFLND), and primary repair. Four and one patients were treated with radical vulvectomy (RV) and modified radical vulvectomy (MRV) [with or without B/L IFLND and PLND] respectively. Reconstruction with V-Y gracilis myocutaneous and local rotation advancement V-Y fasciocutaneous flaps were done in two patients. Therapeutic groin nodal dissection was performed in 19 patients except in one patient who was treated by palliative radical vulvectomy. In the final histopathology reports, tumor size varies from 0.5 to 6.5 cm (mean 3.35 cm) with the predominance of squamous cell carcinoma (18 out of 20 patients). Only 10 out of 18 eligible patients received adjuvant treatment. Poor patient compliance has been one of the major reasons for adjuvant treatment attrition rate. Systemic and loco-regional metastasis occurred in 3 patients each arm respectively. Poor follow up of patients is the key limitation of our study.
Conclusion
Vulvar cancer incidence was significantly high in post-menopausal and multiparous women. The most important prognostic factors were tumor stage and lymph node status. Oncological resection should be equated with functional outcome. The multidisciplinary team approach should be sought for this rare gynecological malignancy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32372283</pmid><doi>10.1186/s43046-019-0015-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4059-8153</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of Egyptian National Cancer Institute, 2020-01, Vol.32 (1), p.4-7, Article 4 |
| issn | 2589-0409 1110-0362 2589-0409 |
| language | eng |
| recordid | cdi_proquest_journals_2729536074 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Springer Nature OA Free Journals |
| subjects | Adult Aged Aged, 80 and over Cancer patients Cancer therapies Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - therapy Care and treatment Cellulitis Chemoradiotherapy, Adjuvant - statistics & numerical data Comorbidity Disease-Free Survival Dissection Female Genital cancers Gynecology Health aspects Histochemistry Histology Histopathology Humans Incidence Inguinofemoral node dissection Kaplan-Meier Estimate Lymph Node Excision Lymphatic Metastasis Lymphatic system Medical research Medicine Medicine & Public Health Medicine, Experimental Melanoma Menopause Middle Aged Modified radical vulvectomy Multi-disciplinary tumor board Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - prevention & control Neoplasm Staging Obstetrics Oncology Palliative care Patient compliance Patient Compliance - statistics & numerical data Patients Postmenopausal women Postoperative period Prospective Studies Radiation therapy Radiotherapy Reconstructive Surgical Procedures - methods Retrospective Studies Risk Factors Skin cancer Squamous cell carcinoma Statistical analysis Stream flow Surgery Surgical Flaps - transplantation Survival Sutures Tomography Trends Tumor staging Vagina Venture capital Vulva - pathology Vulva - surgery Vulvar cancer Vulvar Neoplasms - diagnosis Vulvar Neoplasms - mortality Vulvar Neoplasms - pathology Vulvar Neoplasms - therapy Vulvectomy - adverse effects Vulvectomy - methods Womens health Wound dehiscence |
| title | Vulvar cancer: surgical management and survival trends in a low resource setting |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-12T17%3A37%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Vulvar%20cancer:%20surgical%20management%20and%20survival%20trends%20in%20a%20low%20resource%20setting&rft.jtitle=Journal%20of%20Egyptian%20National%20Cancer%20Institute&rft.au=Kumar,%20Navin&rft.date=2020-01-14&rft.volume=32&rft.issue=1&rft.spage=4&rft.epage=7&rft.pages=4-7&rft.artnum=4&rft.issn=2589-0409&rft.eissn=2589-0409&rft_id=info:doi/10.1186/s43046-019-0015-y&rft_dat=%3Cgale_doaj_%3EA680085080%3C/gale_doaj_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2729536074&rft_id=info:pmid/32372283&rft_galeid=A680085080&rft_doaj_id=oai_doaj_org_article_881051976e154b899f9aab377103ed9b&rfr_iscdi=true |