title: Outcome of vulvar reconstruction by anterolateral thigh flap in patients with advanced and recurrent vulvar malignancy.
abstract: BACKGROUND
  To evaluate the outcomes of vulvar reconstruction using anterolateral thigh (ALT) flaps in patients with advanced and recurrent vulvar malignancies.
  
  
  METHODS
  Totally 24 patients who received ALT-based vulvar reconstruction were retrospectively reviewed to evaluate the outcome focusing on quality of life and prognosis.
  
  
  RESULTS
  Four patients received vulvar reconstruction at the time of primary surgery due to advanced stage, and 20 patients underwent vulvar reconstruction after recurrence. No patient experienced complete flap loss. Major complications happened in five patients (20.83%). Minor complications occurred in three patients (12.5%). All wounds healed favorable after appropriate treatment. The mean scale of verbal rating scale (VRS-4) was 1.58 before reconstruction while decreased to 0.13 after surgery (P < 0.0001). Mean performance status was 1.67 before surgery compared to 0.13 after surgery (P < 0.0001). Fourteen patients (58.33%) developed recurrence with a median interval of recurrence of 5 months after vulvar reconstruction. Ten patients (41.67%) are living with disease free in a median follow-up of 19.5 months. Overall 5 years survival was 56.4%.
  
  
  CONCLUSIONS
  ALT flap based vulvar reconstruction method can improve the quality of life and might be considered as an appropriate option for reconstructing the vulvar defects in patients with advanced or recurrent vulvar malignancy.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Zeng
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Dongyan
authors.initials: D
authors.lastname: Cao
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Huifang
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Plastic Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pathology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: You
authors.affiliation: Department of Pathology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Jinghe
authors.initials: J
authors.lastname: Lang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Keng
authors.initials: K
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011379:Prognosis; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013848:Thigh; D014844:Vulva / Q000473:pathology / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: quality of life; vulvar cancer; vulvar reconstruction