Recurrent Squamous Cell Carcinoma of the Vulva: A Study of 73 Cases

Piura, Benjamin; Masotina, A; Murdoch, J.; Lopes, Alberto; Morgan, P. R.; Monaghan, John M.

doi:10.1006/gyno.1993.1032

Cited by 97 publications

(54 citation statements)

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“…All patients in this study with FIGO stage III/IV had positive lymph nodes. This is in accordance with others who also found positive lymph nodes as a predictive factor [21,32,33]. The primary route of spread in vulvar cancer is by lymphatic embolization to the regional inguinofemoral lymph nodes.…”

Section: Discussionsupporting

confidence: 92%

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Patterns and frequency of recurrences of squamous cell carcinoma of the vulva

Woolderink

Bock

Hullu

et al. 2006

Gynecologic Oncology

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Objective. To analyze patterns and frequency of recurrences of squamous cell carcinoma (SCC) of the vulva after wide local excision (WLE) and superficial inguinal lymphadenectomy with separate incisions and to identify prognostic factors for the development of recurrences.Methods. Between January 1985 and December 1999, all 125 consecutive patients with primary SCC of the vulva, treated with WLE and superficial inguinal lymphadenectomy, were retrospectively analyzed. Recurrences were registered by localization as: local, skin bridge, groin or distant.Results. A local recurrence was diagnosed in 29 (23%) patients, 11 (9%) developed a groin and 4 (3%) a distant recurrence. No skin bridge recurrences were identified. The 5 years local relapse-free survival was 70%. After a first local recurrence, 72% of these patients developed a second local recurrence. Adjusted for other predictors, older age (>74 years) is an independent risk factor for local recurrences (HR: 2.38; 95%-C. I.: 1.08-5.23) and stage III/IV cancer for developing groin/distant recurrences (HR: 3.03; 95%-C.I.: 1.0-9.18).Conclusion. WLE and superficial inguinal lymphadenectomy with separate incisions result in a high groin recurrence rate in this study; superficial lymphadenectomy should be replaced by deep inguinofemoral lymphadenectomy. After a local recurrence, 72% of the patients developed a second local recurrence. These patients are at high risk and need a close follow-up.

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Section: Discussionsupporting

confidence: 92%

“…Oonk et al showed local recurrence rates of 16% in 376 patients and 21% in 238 patients, and Cavanagh et al gave an overview of studies and reported recurrences in 15-40% of which 55-90% were local recurrences [21][22][23]. Wide local excision leaves part of the possible abnormal vulva in situ.…”

Section: Discussionmentioning

confidence: 99%

Patterns and frequency of recurrences of squamous cell carcinoma of the vulva

Woolderink

Bock

Hullu

et al. 2006

Gynecologic Oncology

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“…Their study showed that the size of the lesion, close margins of resection (<1 cm) and lymph node status at primary surgery were the main predictors of recurrence [29]. We found local recurrence in 47% of our patients; the literature figures for this complication range from 53 to 86% [28,29,30,32,33]. Nodal metastases occurred in 39% of our patients, while the literature cites 11–38% [32,33,34,35].…”

Section: Discussionmentioning

confidence: 72%

“…We found local recurrence in 47% of our patients; the literature figures for this complication range from 53 to 86% [28,29,30,32,33]. Nodal metastases occurred in 39% of our patients, while the literature cites 11–38% [32,33,34,35]. Nodal recurrence in primary vulvar carcinoma seems principally related to the depths and size of the tumor as well as vascular invasion [29].…”

Section: Discussionmentioning

confidence: 73%

Characterization of Sociodemographic and Clinicopathological Features in Brazilian Patients with Vulvar Squamous Cell Carcinoma

Maia

Cestari

Lavorato-Rocha

et al. 2012

Gynecol Obstet Invest

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Aim: To investigate sociodemographic and clinical-epidemiological profiles of patients with vulvar carcinoma in São Paulo, the largest city of Brazil, to establish a more consistent profile of these features once the incidence of vulvar carcinoma has risen considerably. Data regarding the epidemiological aspects of this tumor are scarce. Methods: A retrospective study was performed using 300 medical records from patients diagnosed with squamous cell carcinoma of the vulva and surgically treated at A.C. Camargo Hospital in São Paulo, Brazil, from 1978 to 2009. Results: The median age of onset was 70 years, ranging from 15 to 98 years, and most women were white (88.51%). Most patients (83.54%) had little or no schooling and had the lowest survival curve. Many patients were diagnosed in the early stages of the disease (57.09% FIGO IB), 59% had complications due to surgery and 43.71% had disease recurrence, of which about 70% died. Conclusions: Our study adds 300 Brazilian cases of vulvar carcinoma to the world literature. Given the high rate of disease recurrence and mortality in Brazil, we conclude that regular gynecologic evaluation and educational policies should be reinforced in order to raise awareness for vulvar cancer.

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“…The recurrences usually occur within 2 years of the primary treatment and can occur either locally in the vulva, in the inguinal nodes or distant metastasis. Local recurrence in vulva is seen in 69.5 %, groin recurrence in 24.3 %, pelvic nodes in 15.6 % and distant metastasis in 18.5 % [2]. The treatment and the prognosis depends on the extent and the site of the recurrence.…”

Section: Discussionmentioning

confidence: 99%