title: Radical surgery for T1 and T2 squamous cell carcinoma of the vulva through separate incisions.
abstract: OBJECTIVE
  The aim of the study was to retrospectively evaluate treatment results in patients with T1 and T2 vulvar carcinoma.
  
  
  METHODS
  The medical records of 46 patients with T1 and T2 SCC of the vulva undergoing radical excision of the tumor and groin node dissection at Chiang Mai University Hospital between January 1998 and December 2004 were reviewed. The tumor size, histologic grade, nodal status, lymph-vascular space invasion, lesion location, surgical marginal status, complications, recurrence and survival were analyzed.
  
  
  RESULTS
  Mean age of the 46 patients (T1 = 15, T2 = 31) was 59 years with a range of 34-84 years. The incidence of lymph node metastases for T1 lesions was 13% compared to 35% for T2 lesions. Twenty nine patients (63%) experienced surgical complications, the most common one was lymphedema (16) while wound breakdown was noted in only 1 patient. With a median follow-up of 15 months, 14 patients (30%) developed recurrence, 3 (20%) and 11 (35%) in patients with T1 and T2 lesions respectively. The overall 5-year disease-free survival and 5-year survival were 37% and 40%, respectively. The 5-year survival of patients with T1 lesion was significantly higher than that of patients with T2 lesion (64% vs 31%, P = 0.04). Patients with negative nodes had significantly better survival than those with positive nodes (56% vs 18%, P = 0.02). In multivariable analysis, only the status of groin node remained as independent prognostic factors for survival.
  
  
  CONCLUSIONS
  Radical excision and groin node dissection through separate incision for T1 and T2 squamous cell carcinoma of the vulva in this study has a less favorable survival outcome compared with the literature.
authors.affiliation: Department of Obstetrics & Gynecology Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. khobjai@hotmail.com
authors.forename: Apichart
authors.initials: A
authors.lastname: Khobjai
authors.forename: Jatupol
authors.initials: J
authors.lastname: Srisomboon
authors.forename: Kittipat
authors.initials: K
authors.lastname: Charoenkwan
authors.forename: Chailert
authors.initials: C
authors.lastname: Phongnarisorn
authors.forename: Prapaporn
authors.initials: P
authors.lastname: Suprasert
authors.forename: Sitthicha
authors.initials: S
authors.lastname: Siriaree
authors.forename: Chalong
authors.initials: C
authors.lastname: Cheewakriangkrai
authors.forename: Charuwan
authors.initials: C
authors.lastname: Tantipalakorn
authors.forename: Chumnan
authors.initials: C
authors.lastname: Kietpeerakool
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*