Impact of vulvar reconstruction on the accuracy of a nomogram for predicting local recurrence after surgery for vulvar cancer

Parpex, Guillaume; Bucau, Margot; Estevez, Juan Pablo; Raimond, Émilie; Ouldamer, Lobna; Carcopino, Xavier; Touboul, Cyril; Bendifallah, Sofiane; Graesslin, Olivier; Lavoué, Vincent; Bolze, Pierre‐Adrien; Koskas, Martin

doi:10.1016/j.ygyno.2022.02.008

Cited by 2 publications

(3 citation statements)

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“…Previous studies reported that the recurrence rate of vulvar cancer ranged from 14.5% to 21.2%, whereas the complication rate was 7.7% to 57.4% after vulvar reconstruction 11,13,18,24,25 . Because of the reconstruction uses the surrounding tissue, vulvar cancer showed a relatively higher recurrence rate in vulvar reconstruction.…”

Section: Discussionmentioning

confidence: 96%

“…Previous studies reported that the recurrence rate of vulvar cancer ranged from 14.5% to 21.2%, whereas the complication rate was 7.7% to 57.4% after vulvar reconstruction. 11,13,18,24,25 Because of the reconstruction uses the surrounding tissue, vulvar cancer showed a relatively higher recurrence rate in vulvar reconstruction. In addition, it showed a high surgical complication rate because the surgical site was a weight bearing site in the sitting position and a site where urine and feces is discharged.…”

Section: Discussionmentioning

confidence: 99%

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A Simplified Algorithmic Approach to Vulvar Reconstruction According to Various Types of Vulvar Defects

2023

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Objective Various surgeons adopt various vulvar reconstruction methods for different types of vulvar defects to restore anatomical structures. Vulvar reconstruction has relatively few references as it is performed in many different ways. Our report aimed to create a simplified reconstruction algorithm that can be used to select the reconstruction flap and to compare clinical outcomes. Methods The patients who underwent vulvar reconstruction between April 2017 and May 2020 were retrospectively reviewed. The reconstruction flap was selected according to a suggested algorithm, which accounted for the defect location depending on the vulvo-thigh junctional crease—the visual landmark of the inferior pubic ramus—and proper perforator location. Postoperative surgical complications, functional outcomes, and oncologic outcomes were analyzed according to the histologic and flap types. Results Forty-seven patients underwent reconstruction with 31 internal pudendal artery perforator flaps (66%) and 16 profunda artery perforator flaps or transverse upper gracilis flaps (34%). The histologic type included 21 extramammary Paget disease (44.7%), 20 squamous cell carcinoma (42.6%), and 6 other types (12.8%). Postoperative complications, including wound and functional complications, occurred in 10 patients (21.3%). There were more cases of wound complications with profunda artery perforator flaps and transverse upper gracilis flaps (37.5%) than those with internal pudendal artery perforator flaps (12.9%) (P = 0.04). There were 7 cases (14.9%) of 2-year oncologic recurrence with no significant differences in terms of histologic or flap types. Conclusions According to our suggested simplified algorithm, various types of flaps resulted in reliable surgical outcomes with minimal complication rates and acceptable functional and oncologic outcomes, and the primary goals of vulvar reconstruction were achieved effectively. Using our algorithm, selection of the reconstruction method could be simplified and specified despite the complexity of vulvar defects.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

A Simplified Algorithmic Approach to Vulvar Reconstruction According to Various Types of Vulvar Defects

2023

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“…Fortunately, after adjuvant therapy almost all vulvar tumors can be surgically removed and an associated vulvar reconstruction can be performed. Reconstruction, in fact, can improve the prognosis of locally advanced cancer by increasing healthy resection margins [36]. This makes it possible to have a higher rate of first surgery in multidisciplinary centers with plastic surgeons.…”

Section: Advanced Stagementioning

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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Impact of vulvar reconstruction on the accuracy of a nomogram for predicting local recurrence after surgery for vulvar cancer

Cited by 2 publications

References 20 publications

A Simplified Algorithmic Approach to Vulvar Reconstruction According to Various Types of Vulvar Defects

A Simplified Algorithmic Approach to Vulvar Reconstruction According to Various Types of Vulvar Defects

Therapeutic Approaches to Vulvar Cancer: A Review of Literature

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