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Pelvic exenteration for the treatment of vulvar cancer
Author(s) -
Hopkins Michael P.,
Morley George W.
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19921215)70:12<2835::aid-cncr2820701219>3.0.co;2-u
Subject(s) - medicine , pelvic exenteration , vulvar cancer , surgery , lymph node , survival rate , vulva
Abstract Background . Advanced vulvar cancer can be treated by pelvic exenteration. Methods . A clinical review of patients treated by exenteration surgery for vulvar cancer was performed. Results . From 1950 through 1989, 19 patients underwent pelvic exenteration for advanced or recurrent squamous cell cancer of the vulva. The mean age was 53 years (median, 50 years; range, 40–74 years). The cumulative 5‐year survival was 60%. Fourteen patients had posterior exenteration; 2 had anterior exenteration; and 3 had total exenteration. The survival was significantly influenced by lymph node status. When lymph nodes were not involved, 10 of 14 patients survived, whereas all 5 patients with lymph node involvement died of disease (P = 0.002). When exenteration was performed as primary therapy, 7 of 11 patients survived, whereas 3 of 8 survived when exenteration was performed for recurrent disease (P = 0.4). The extent of vulvar involvement did not influence survival (P = 0.99). There was no mortality, but ten patients had complications, including vesi‐covaginal fistula (three): stomal hernia (two): abscess (one); stress urinary incontinence (one); deep venous thrombosis (one); conduit leak (one); enterocutaneous fistula (one); and small intestinal obstruction (one). Conclusions . Acceptable survival for advanced or recurrent vulvar cancer can be achieved with pelvic exenteration, but the presence of metastatic disease to lymph nodes markedly decreases survival.

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