Initial surgical management of squamous carcinoma of the vulva

• Published in: Gaceta médica de México Vol. 152; no. 3; pp. 297 - 303
• Main Authors: Salazar-Báez, Israel, Salazar-Campos, Jessica E, López-Arias, Alhely, Villavicencio-Valencia, Verónica, Coronel-Martínez, Jaime, Candelaria-Hernández, Myrna, Pérez-Montiel, Delia, Pérez-Plasencia, Carlos, Rojas-García, Aurora Elizabeth, Cantú de León, David
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.05.2016
• Subjects: Aged; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Retrospective Studies; Survival Rate; Vulvar Neoplasms - pathology; Vulvar Neoplasms - surgery
• ISSN: 0016-3813

Vulvar cancer accounts for approximately 4% of gynecological malignancies. At the Instituto Nacional de Cancerologia in Mexico it occupies the fourth place. The purpose of this study is to assess the management of squamous carcinoma of the vulva with initial surgical treatment. It is a descriptive retrospective, observational study, from January 1, 2002 to December 31, 2012. Twenty-seven patients, clinical stages I, II, or III, initial surgical management, with at least one year of follow-up were included. In 51.85% a partial vulvectomy was performed and in 40.74% a wide excision; 66.66% underwent inguinofemoral dissection. Recurrence occurred in 25.91% of cases and the overall survival at 10 years was 63%. It is concluded that with invasion of up to 1 mm of lymph node, affection is 0%; with invasion of 1 mm and up to 5 mm this increases to 25%; an invasion of more than 5 mm implies up to 45%. Recurrence in our study was primarily distant, necessitating long-term monitoring with emphasis on symptoms to request imaging studies when suspected. Adjuvant therapy should be offered to patients with positive nodes, close or positive margins, and tumors larger than 4 cm.