title: Recurrent squamous carcinoma of the vulva.
abstract: OBJECTIVE
  This study reviews experience at Indiana University with recurrent squamous carcinoma of the vulva over an 18-year period from 1971 to 1989. The pattern of recurrence, time interval to recurrence, and efficacy of salvage therapy are evaluated in the context of the primary tumor.
  
  
  METHODS
  This is a retrospective study of 40 patients, 21 of whom underwent primary therapy for invasive squamous carcinoma of the vulva at Indiana University.
  
  
  RESULTS
  Vulvar recurrences were observed in 17 patients (43%), the groin was involved in 12 (30%), whereas pelvic and distant recurrences were observed in 2 (5%) and 9 (22.5%) patients, respectively. Salvage surgery and/or radiotherapy were successful in 25 patients (62.5%) alive from 1 to 144 months (median 8 months) from secondary therapy. Survival after retreatment varied significantly by site of recurrence (p = 0.002), tumor grade (p = 0.009), and interval to recurrence (p < 0.001). Best outcomes were in patients with initial stage I or II disease (International Federation of Gynecology and Obstetrics), grade 1 tumors, local failure, and interval to relapse of > 16 months' duration. Two of 12 patients with groin recurrences were salvaged with surgery and radiotherapy.
  
  
  CONCLUSIONS
  Long-term follow-up of patients with vulvar cancer and careful restaging at the time of recurrence are mandatory. Although local and nodal recurrences may be controlled with surgery and/or radiotherapy, regional recurrences are usually fatal.
authors.affiliation: Department of Radiation Oncology, Indiana University Medical Center, Indianapolis 46202-5274.
authors.forename: A S
authors.initials: AS
authors.lastname: Tilmans
authors.forename: G P
authors.initials: GP
authors.lastname: Sutton
authors.forename: K Y
authors.initials: KY
authors.lastname: Look
authors.forename: F B
authors.initials: FB
authors.lastname: Stehman
authors.forename: C E
authors.initials: CE
authors.lastname: Ehrlich
authors.forename: N B
authors.initials: NB
authors.lastname: Hornback
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014846:Vulvar Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy