Feto-maternal outcome of pregnancy complicated by vulvar cancer: a systematic review of literature

Matsuo, Koji; Whitman, Stephanie A.; Blake, Erin A.; Conturie, Charlotte L.; Ciccone, Marcia A.; Jung, Carrie E.; Takiuchi, Tsuyoshi; Nishimura, Masato

doi:10.1016/j.ejogrb.2014.04.017

Cited by 33 publications

(39 citation statements)

References 37 publications

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“…160 Although research on the prognosis of cancer during pregnancy is limited, a few meta-analyses and systematic reviews have suggested that the prognosis of certain cancers (eg, breast, melanoma, vulvar) may be worse when occurring concurrent with pregnancy compared to the same cancers occurring outside pregnancy. [161][162][163][164] These results may be confounded by factors related to the patients' pregnancy, delays in diagnosis, and differences in treatment decisions, making a definitive conclusion difficult.…”

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

239

194

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Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

239

194

View full text Add to dashboard Cite

“…In comparison to all gynecological cancers in pregnancy, VC is in fact considered to have the least possible complications in patients who undergo biopsy and/or operation. [28][29][30] No groin recurrence was reported in Group 2 (bilateral IFL after unilateral SLN metastasis detected) of our study after initial follow-up at 12 months. One woman with positive contralateral LN in IFL in subgroup 2C passed away due to lung metastasis, with history of being immunosuppressed following kidney transplantation.…”

Section: Discussionmentioning

confidence: 50%

“…28 Likewise, delivery mode should then be evaluated on a case-by-case basis; dependent on the probability of vulvar wound dehiscence and/or degree of scar tissue stenosis. [28][29][30] In our study, the pregnant woman with VC delivered her baby via caesarean section.…”

Section: Discussionmentioning

confidence: 89%

The Possibility of Contralateral Non-Sentinel Groin Node’s Metastasis in Early Primary Vulvar Cancer Women After Unilateral Sentinel Node’s Metastasis: A Single Center Evaluation in University Hospital of Düsseldorf

Winarno¹,

Mondal²,

Martignoni³

et al. 2020

Preprint

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Background: Sentinel node biopsy (SLNB) technique in unifocal vulvar cancer (diameter of < 4cm) and unsuspicious groin lymph nodes, the morbidity rate of patients has significantly decreased all over the world. In contrast to SLNB, bilateral inguinofemoral lymphadenectomy (IFL) has been associated with increased risk of common morbidities. Current guidelines (NCCN, ESGO, RCOG, and German) suggest that in cases of metastasis of unilateral SLNB, groin node dissection with IFL, should be performed bilaterally. However, a publication by Woelber et al. 0% (p=0/28) and Nica et al. 5.3% (p=1/19) contradicted the current guideline. Methods: A single-center analysis conducted in the University Hospital of Dusseldorf, evaluating vulvar cancer patients treated with SLNB retrospectively from 2002 to 2018. Result, discussion and conclusion: Current guideline for bilateral IFL should remain as the standard management because 22.2% women (n=4/18) had contralateral IFL groin metastasis after unilateral SLNB metastasis initially. The depth of tumor infiltrating cells was correlated significantly and positively with the incidence rate of groin metastasis (p=0.0038). Therefore, it is an indication for bilateral IFL.

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“…For vulvar carcinoma, surgical therapy, including wide local excision, simple vulvectomy and radical vulvectomy, with or without bilateral inguinal lymph node dissection, are currently the standard treatment. In certain cases, however, radiotherapy with or without chemotherapy may also be performed in addition to surgical therapy (8,9).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy and cesarean delivery after multimodal therapy for vulvar carcinoma: A case report

Toriyabe

Taniguchi

Senda

et al. 2016

Molecular and Clinical Oncology

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Abstract. Reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon, as the main problem of subsequent pregnancy is vulvar scarring following radical surgery. We herein report the case of a patient who was diagnosed with stage I squamous cell carcinoma of the vulva at the age of 17 years and was treated with multimodal therapy, including neoadjuvant chemotherapy, wide local excision with bilateral inguinal lymph node dissection and adjuvant radiotherapy. The patient became pregnant spontaneously 9 years after her initial diagnosis and the antenatal course was good, except for mild acute pyelonephritis at 25 weeks of gestation. An elective caesarean section was performed at 38 weeks of gestation due to vulvar scarring following multimodal therapy, particularly radiotherapy. The patient remains alive and well, without signs of recurrence or metastasis 12 years after her diagnosis and treatment. Radical vulvectomy as well as multimodal therapy for vulvar carcinoma, particularly radiotherapy, may cause extensive skin scarring. The presence of vulvar scarring following multimodal therapy for vulvar carcinoma may increase the incidence of caesarean delivery. IntroductionAs carcinoma of the vulva is rare among young women, reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon. The incidence of vulvar carcinoma, however, has recently increased among younger women; thus, there may have been an increase in pregnancy rates following vulvar carcinoma treatment (1). Pregnant women who undergo surgical treatment for vulvar carcinoma, including radical vulvectomy, may have an increased incidence of caesarean delivery (2). In the literature, vulvar scarring following radical vulvectomy was the major reason for pregnant women undergoing caesarean section (2-7). To date, no cases of pregnancy following vulvar carcinoma have been reported in patients who had undergone surgery and radiotherapy.We herein describe a case in which caesarean section was performed due to the presence of extensive vulvar scarring following multimodal therapy for vulvar carcinoma, including chemotherapy, surgery and radiotherapy. Case reportIn April, 2003, a 17-year-old, nulligravida Japanese woman, who was a smoker, presented with a 4-month history of a mass (sized >2 cm) with accompanying pruritus in the left labium majus (Fig. 1). Examination of biopsy specimens revealed invasive squamous cell carcinoma with keratin pearl formation and stromal invasion >1 mm in depth (Fig. 2). Screening for sexually transmitted infections, including HIV serology, syphilis serology, Chlamydia trachomatis polymerase chain reaction and Neisseria gonorrhoeae polymerase chain reaction were performed, and were all negative. The serum squamous cell carcinoma antigen level was 2.6 ng̸ml (normal value, <1.5 ng̸ml). Magnetic resonance imaging (MRI) revealed enlarged inguinal lymph nodes bilaterally. The patient first underwent neoadjuvant chemotherapy (pepleomycin, 5 mg̸body intramuscular injection twice a week for 2.5 we...

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Feto-maternal outcome of pregnancy complicated by vulvar cancer: a systematic review of literature

Cited by 33 publications

References 37 publications

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

The Possibility of Contralateral Non-Sentinel Groin Node’s Metastasis in Early Primary Vulvar Cancer Women After Unilateral Sentinel Node’s Metastasis: A Single Center Evaluation in University Hospital of Düsseldorf

Pregnancy and cesarean delivery after multimodal therapy for vulvar carcinoma: A case report

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