Carcinoma of the vulva (1981-1985): analysis of a radio-surgical approach.
Carcinoma of the vulva has recently been the subject of renewed interest of gynecologists and oncologists. That which is commonly defined as the "choice" treatment is a radical vulvectomy with bilateral inguinal lymphadenectomy and, in the case of lymph node metastases, pelvic lymphadenectomy. The usefulness of the pelvic dissection has, however, been disputed and various Authors have proposed an alternative treatment consisting of radical vulvectomy and inguinal lymphadenectomy with external radiotherapy on the inguinal and pelvic lymph nodes, in the case of N+. The present report describes 56 patients with vulvar carcinoma treated at the Regina Elena National Cancer Institute of Rome, 42 of whom were submitted to radical surgery. In 14 of these patients, metastases in the inguinal lymph nodes were found: 10 were submitted to radiotherapy (with TCT or low voltage linear accelerator for a total of 50 Gy over a 5-week period), while the remaining 4 were not treated with any further therapy. Although the survey includes only a limited number of patients, the results obtained certainly favor radio-surgical treatment, also considering data reported in international literature regarding pelvic lymphadenectomy. The actuarial 5-year survival rates for the patients treated with surgery plus radiotherapy is 50% and the recurrence rate is 20%. Although a greater experience is certainly warranted in this field, we believe it may be stated (also on the basis of a recent study conducted by the Gynecologic Oncology Group) that radiotherapy represents a valid alternative to pelvic dissection if an adequate patients selection is made.
Atlante
G
G
Department of Gynecological Oncology, Regina Elena National Cancer Institute, Rome, Italy.
Lombardi
A
A
Mariani
L
L
Vincenzoni
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D014846:Vulvar Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*