Definitive chemoradiation or radiation therapy alone for the management of vulvar cancer

Barry, Parul; Ling, Diane C.; Beriwal, Sushil

doi:10.1136/ijgc-2021-002530

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…The stability of survival from vulvar cancer may be considered a favourable result only from the perspective that there is currently a trend toward less extensive vulvar surgery [ 43 ] and increasing use of the sentinel lymph node biopsy in tumours <4 cm in size [ 44 ] and of the radio–chemo therapeutic approach in late-stage disease [ 45 ]. This was the conclusion, for example, of a U.S. study reporting a stable trend in 5-year overall and disease-specific survival from stage III–IV vulvar cancer between 1988 and 2007 [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

Mancini

Bucchi

Zamagni

et al. 2023

JCM

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(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990–2001 to 81.9% in 2009–2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70–79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003–2015 versus 1990–2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level.

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Section: Discussionmentioning

confidence: 99%

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

Mancini

Bucchi

Zamagni

et al. 2023

JCM

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“…The approach to recurrence must be multidisciplinary and personalized based on the patient's frailty status and on the characteristics of the primary tumor, as well as of recurrence [53,54].…”

Section: Treatment Of Recurrencementioning

confidence: 99%

Therapeutic Approaches to Vulvar Cancer: A Review of Literature

D’Augè¹,

Firulli²,

Bartolomeo³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Objective: Vulvar cancer is a rare gynecological cancer that mainly affects postmenopausal women. The aim of this review is to analyze the most recent data available in the literature on the clinical and therapeutic approach to vulvar carcinoma. Mechanism: Studies available in the literature on the therapeutic management of patients with vulvar carcinoma until November 2022 have been screened. A comprehensive search was performed in the PubMed (MEDLINE), EMBASE, SCOPUS and Web of Science databases. Findings in Brief: The approach to vulvar carcinoma has deeply evolved over the years. The management of early-stage vulvar carcinomas is well established and widely shared, while that of advanced and recurrent cancers is a subject of debate. The assessment of the nodal status has changed from the past with the passage from inguinal lymphadenectomy to the removal of only the sentinel node. Conclusions: The gold standard for the management of vulvar cancer is surgery, applicable in the first instance in early-stage tumors and after neoadjuvant therapy for larger tumors. Assessment of the nodal state is crucial and the method to be used depends on the degree of suspicious of positive lymph nodes. The prognosis is good if the treatment is applicable as soon as possible.

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“…Radical local excision and inguinofemoral sentinel lymphadenectomy, or the removal of the tumor with an adequate margin, has become a common form of vulvar surgery, replacing radical vulvectomy with systematic inguinofemoral lymphadenectomy [ 3 , 4 , 5 , 6 , 7 ]. In the case of early-stage vulvar cancer with high-risk features, radiation therapy or combined radiochemotherapy must be considered [ 5 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Tumor-Free Resection Margin Distance in the Surgical Treatment of Node-Negative Squamous Cell Cancer of the Vulva Has No Impact on Survival: Analysis of a Large Patient Cohort in a Tertiary Care Center

Taran

Pasternak²,

Staebler

et al. 2023

Cancers

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Background: The aim of this study was to evaluate the impact of pathological tumor-free margin distance on survival in SCC patients treated with surgery alone. Methods: This retrospective study included 128 patients with node-negative disease that received no adjuvant treatment. Disease-free and overall survival were analyzed according to pathological tumor-free margin distance. Results: The patients were subclassified into three resection margin category groups: “1 to 3 mm” (n = 42), “>3 to 8 mm” (n = 47) or “>8 mm” (n = 39). Thirty-nine of the 128 patients (30.5%) developed recurrent disease. Median follow-up for disease-free survival (DFS) was 6.49 years (95% CI 5.16 years; 7.62 years), and median follow-up for overall survival (OS) was 6.29 years (95% CI 5.45 years; 7.33 years). The 5-year DFS rate was 0.70 (95% CI: 0.62–0.79), and the 5-year OS rate was 0.79 (95% CI: 0.71–0.87). Regarding the survival outcome, there were no independent significant differences in either disease-free survival (DFS) (p = 0.300) or overall survival (p = 1.000) among patients within the three tumor-free resection margin categories. Multivariate analyses did not show any statistically significant association between tumor-free resection margin distance and recurrent disease or death, either when analyzed as a categorical variable or when analyzed as a continuous variable. Conclusion: The present study did not show a significant impact of pathological tumor-free resection margin distance following surgery in patients with node-negative SCC of the vulva (that did not receive adjuvant treatment) on disease-free and overall survival.

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Definitive chemoradiation or radiation therapy alone for the management of vulvar cancer

Cited by 4 publications

References 31 publications

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

Therapeutic Approaches to Vulvar Cancer: A Review of Literature

Tumor-Free Resection Margin Distance in the Surgical Treatment of Node-Negative Squamous Cell Cancer of the Vulva Has No Impact on Survival: Analysis of a Large Patient Cohort in a Tertiary Care Center

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