The management of carcinoma of the vulva: current opinion and current practice among consultant gynaecologists in Scotland.
A postal questionnaire survey of all 126 consultant gynaecologists in Scotland was undertaken in order to obtain an overview of current opinion and current practice in relation to the management of vulval carcinoma. The response rate was 95%. Fifteen suggested criteria for good quality care were validated by a balance of agreement among respondents. There was particularly strong agreement (> 90% of respondents) that vulval carcinoma should be managed by subspecialists rather than generalists, that en bloc radical vulvectomy is not always required, that patients should be informed of their diagnosis and that long-term follow-up is required. There was least agreement (< 50% of respondents) that groin lymphadenectomy may be omitted in selected cases and that follow-up need be at special multidiscipline clinics. An encouraging picture of current practice emerged. Very few consultants who do not profess to be oncology subspecialists would manage cases alone, few perform en bloc radical vulvectomy in all cases and few undertake deep pelvic lymphadenectomy. Most acknowledge the importance of psychosexual issues and all generally inform patients of the nature of their diagnosis. The postal questionnaire approach achieved a good response rate and has provided an informative overview of current opinion and practice on a national basis. This approach may be more valuable than case-note review audit in providing a meaningful picture of contemporary practice for uncommon conditions like vulval cancer.
Penney
G C
GC
Department of Obstetrics and Gynaecology, Maternity Hospital, Aberdeen.
Kitchener
H C
HC
Templeton
A
A
D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D006176:Gynecology; D006801:Humans; D010348:Patient Care Team; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014846:Vulvar Neoplasms / Q000601:surgery* / Q000628:therapy