Survival Benefit of Adjuvant Radiation Therapy in Node-positive Vulvar Cancer

Xanthopoulos, Eric; Grover, Surbhi; Puri, Priya; Corradetti, Michael N.; Heilbroner, Samuel P.; Mitra, Nandita; Simone, Charles B.; Lin, Lilie L.

doi:10.1097/coc.0000000000000393

Cited by 19 publications

(23 citation statements)

References 15 publications

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“…Despite these national recommendations, several recent studies have questioned this policy [12][13][14][15][17][18][19]. A summary of the literature on this subject is shown in Table 4.…”

Section: Discussionmentioning

confidence: 99%

“…A summary of the literature on this subject is shown in Table 4. Six out of 10 published studies recommend adjuvant radiotherapy in all patients, irrespective of the number of positive lymph nodes [12][13][14][15]17,19]. Three other studies do not recommend adjuvant radiotherapy [5,6,16], while the large AGO study could not show a significant difference in recurrence free survival with or without adjuvant radiotherapy and was therefore considered inconclusive [18].…”

Section: Discussionmentioning

confidence: 99%

“…The current ESGO guidelines [4] and most, but not all [7] other guidelines, recommend adjuvant radiotherapy, except for patients with one clinically occult and pathologically intracapsular lymph node metastasis [8][9][10][11]. However, some recent publications have questioned these recommendations and have recommended adjuvant radiotherapy for all patients with lymph node metastases, irrespective of the number and/or pathological characteristics of these metastases [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Radiotherapy is not indicated in patients with vulvar squamous cell carcinoma and only one occult intracapsular groin node metastasis

Velden

Pleunis

Barlow

et al. 2021

Gynecologic Oncology

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“…Despite these national recommendations, several recent studies have questioned this policy [12][13][14][15][17][18][19]. A summary of the literature on this subject is shown in Table 4.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radiotherapy is not indicated in patients with vulvar squamous cell carcinoma and only one occult intracapsular groin node metastasis

Velden

Pleunis

Barlow

et al. 2021

Gynecologic Oncology

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show abstract

“…Even the tumor-free pathological resection margin distance of < 8 mm, long considered as a signi cant risk factor of vulvar recurrence, has lately been challenged as being associated with local recurrence [18]. Patients with multiple positive LNs bene t from adjuvant radiation therapy following surgery, yet in patients with a single positive LN the survival bene t still remains debatable [19][20][21]. Likewise, the role of adjuvant chemoradiotherapy in patients with LN involvement, as well as of neoadjuvant treatment modalities in advanced VSCC cases are not well de ned.…”

Section: Discussionmentioning

confidence: 99%

Inflammation as a Driver of Vulvar Squamous Cell Carcinoma Progression.

Fatalska¹,

Rusetska²,

Bakuła-Zalewska³

et al. 2020

Preprint

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Background A knowledge on the biology of squamous cell vulvar carcinoma (VSCC) is limited. We aimed to identify protein markers of VSCC tumors stratifying patients by progression risk. Early stage VSCC tumors from patients who progressed (progVSCC) and from those who were disease-free (d-fVSCC) during follow-up, along with normal vulvar tissues were examined by mass spectrometry-based proteomics.Results In progVSCC vs d-fVSCC tumors, the immune response was the most over-represented Gene Ontology category for the identified DEPs. Interestingly, pathway profiling suggested bacterial infections to be linked to aggressive VSCC phenotypes. Differentially expressed proteins (DEPs) were verified in solid tissues and blood samples of patients with VSCC tumors and vulvar premalignant lesions. High Mobility Group AT-Hook 2 (HMGA2) and Proteinase 3 (PRTN3) were revealed as protein markers predicting VSCC progression.Conclusions HMGA2 and PRTN3 abundances are associated with aggressive VSCC phenotype, and hold promise as markers for patient stratification. It appears that vulvovaginal microflora disturbances trigger inflammatory response contributing to cancer progression.

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“…Human papillomavirus (HPV) infection is thought to be the cause of more than 50% vulvar cancer cases. 4,5 The main symptomps of vulvar cancer are itchiness and mass in vulvar area. 6 However, these symptomps are often neglected due to lack of knowledge.…”

Section: Introductionmentioning

confidence: 99%

Response to External Radiation and Interstitial Brachytherapy in Bulky Vulvar Cancer

Dewi

2021

Radioter Onkol Indones

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Vulvar cancer is a gynaecologic malignancy with an incidence of 3-5% of all gynaecologic malignancies. In Indonesia, number of new cases of vulvar cancer reaches 1153 cases with a mortality rate of 420. To establish diagnosis and exclude differential diagnosis for vulvar mass, a histopathological examination is needed. Multimodal therapy is the main therapy of vulvar cancer at advanced stage which consists of surgery, radiotherapy, and chemotherapy. The role of brachytherapy as adjuvant therapy combined with external beam radiotherapy (EBRT) is widely studied, there is still no guideline however it can be considered for tumour near critical organ such as bladder, rectum, urethra, or vagina. Interstitial brachytherapy can be used as adjuvant post EBRT. A boost vary from 2 Gy equivalent dose (EQD2) 16-24 Gy 10 can be considered to be given after EBRT. The purpose of writing this case report is to assess the response of radiotherapy in the form of EBRT and brachytherapy use the MUPIT applicator in patients with vulvar cancer. Here is a case report of a patient with diagnosis of grade IIIC vulvar cancer. From the relevant studies, brachytherapy did not improved overall survival (OS) and disease specific survival (DSS) however in post hoc analysis, brachytherapy as consolidation therapy can improve DSS in patient with FIGO stage IVA, node positive disease, or tumor size > 4 cm. It can be concluded that the combination of EBRT and brachytherapy can be one of the therapeutic modality of choice in vulvar cancer.

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Survival Benefit of Adjuvant Radiation Therapy in Node-positive Vulvar Cancer

Abstract: All node positive vulvar cancer patients should benefit from and thus should receive adjuvant radiation, including those with one positive node.

Cited by 19 publications

References 15 publications

Radiotherapy is not indicated in patients with vulvar squamous cell carcinoma and only one occult intracapsular groin node metastasis

Radiotherapy is not indicated in patients with vulvar squamous cell carcinoma and only one occult intracapsular groin node metastasis

Inflammation as a Driver of Vulvar Squamous Cell Carcinoma Progression.

Response to External Radiation and Interstitial Brachytherapy in Bulky Vulvar Cancer

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