title: Treating vulvar cancer in the new millennium: are patients receiving optimal care?
abstract: OBJECTIVE
  The purpose of our study is to describe patterns of care of invasive vulvar carcinoma in the province of Ontario, Canada. Our ultimate goal is to improve vulvar cancer care by understanding variations in care and their impact on outcome. In this pilot study, we specifically evaluate the use of groin node dissection (GND).
  
  
  METHODS
  The provincial cancer registry was used to identify incident cases of vulvar carcinoma diagnosed between 1994 and 2003. These cases were linked to physician billings claims and hospital discharge records to identify treatment given in the first year after diagnosis.
  
  
  RESULTS
  The cohort included 978 women with vulvar carcinoma. 85% had at least one surgical procedure. 62% of these had a GND. GND was more likely in those who were treated by a gynecologic oncologist or who had less co-morbid illness. Approximately 25% received radiotherapy.
  
  
  CONCLUSIONS
  The rate of GND appears to be low. As proper management of the groins is critical for most patients with vulvar cancer, this observation raises concerns about the quality of treatment received by patients with vulvar carcinoma. Further investigation is required to verify the observations made in this hypothesis generating study.
authors.affiliation: Sunnybrook and Women's College Health Science Center, Canada. lisa.barbera@sunnybrook.ca
authors.forename: Lisa
authors.initials: L
authors.lastname: Barbera
authors.forename: Gillian
authors.initials: G
authors.lastname: Thomas
authors.forename: Laurie
authors.initials: L
authors.lastname: Elit
authors.forename: Al
authors.initials: A
authors.lastname: Covens
authors.forename: Anthony
authors.initials: A
authors.lastname: Fyles
authors.forename: Ray
authors.initials: R
authors.lastname: Osborne
authors.forename: Lingsong
authors.initials: L
authors.lastname: Yun
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009864:Ontario / Q000453:epidemiology; D010865:Pilot Projects; D015996:Survival Rate; D014846:Vulvar Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*