title: Relevance of computerized tomography in the preoperative evaluation of patients with vulvar cancer: a prospective study.
abstract: BACKGROUND
  The purpose of the study was to determine whether inclusion of computerized tomography (CT) in the prospective evaluation of vulvar cancer changed the surgical treatment strategy in terms of detection of lymph node metastases, tumor spread and comorbidity, and additionally to examine the logistical influence of adding further examinations prior to treating out-hospital patients referred from geographically distant areas.
  
  
  METHODS
  During an 8 month period we conducted a prospective study of patients with newly diagnosed or recurrent vulvar cancer consecutively referred to Copenhagen University Hospital, Rigshospitalet. The patients underwent a gynecological examination, chest x-ray and a preoperative CT scanning of the chest, abdomen and pelvis. It was registered whether the radiological findings regarding the extent of the tumor, lymph node involvement, incidental findings and comorbidity changed the surgical treatment plan. Further, the logistical influence of the long referral distances was registered.
  
  
  RESULTS
  Thirty patients with a median age of 69 years (range 44-93 years) were included in the study. CT did not significantly change the initial surgical treatment plan for the patients. CT did not reveal lymph node enlargement outside the inguinofemoral area and was inaccurate compared to the sentinal node examination of the local lymph nodes. CT diagnosed no cases with distant metastases from the primary malignancy, but two cases with a secondary malignant disease were found.
  
  
  CONCLUSIONS
  CT scanning has no clinical impact as a routine screening examination prior to surgery. It may delay treatment, but can add important information when clinically indicated.
authors.affiliation: Department of Radiology, Rigshospitalet, University Hospital Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. kjeldandersen@dadlnet.dk.
authors.forename: Kjeld
authors.initials: K
authors.lastname: Andersen
authors.affiliation: Department of Obstetrics and Gynecology, Rigshospitalet, University Hospital Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. vibeke.zobbe@regionh.dk.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Zobbe
authors.affiliation: Department of Obstetrics and Gynecology, Rigshospitalet, University Hospital Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. ingrid.regitze.thranov@regionh.dk.
authors.forename: Ingrid Regitze
authors.initials: IR
authors.lastname: Thranov
authors.affiliation: Department of Radiology, Rigshospitalet, University Hospital Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. karen.damgaard.01@regionh.dk.
authors.forename: Karen Damgaard
authors.initials: KD
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000601:surgery; D057234:Preoperative Period; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D014057:Tomography, X-Ray Computed; D014846:Vulvar Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*