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Carcinoma vulva: Ten years experience in a teaching institution of North India

INTRODUCTION: Vulvar carcinoma is primarily a disease of post-menopausal women. Surgery is a primary treatment strategy. Chemotherapy and radiotherapy are a part of multimodal therapy. Presently, there is a shift towards neoadjuvant chemotherapy or radiotherapy so as to decrease the surgical morbidi...

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Autores principales: Goyal, Lajya Devi, Kaur, Balpreet, Bhalla, Shivali, Garg, Pardeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10259558/
https://www.ncbi.nlm.nih.gov/pubmed/37312782
http://dx.doi.org/10.4103/jfmpc.jfmpc_1731_22
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author Goyal, Lajya Devi
Kaur, Balpreet
Bhalla, Shivali
Garg, Pardeep
author_facet Goyal, Lajya Devi
Kaur, Balpreet
Bhalla, Shivali
Garg, Pardeep
author_sort Goyal, Lajya Devi
collection PubMed
description INTRODUCTION: Vulvar carcinoma is primarily a disease of post-menopausal women. Surgery is a primary treatment strategy. Chemotherapy and radiotherapy are a part of multimodal therapy. Presently, there is a shift towards neoadjuvant chemotherapy or radiotherapy so as to decrease the surgical morbidities. OBJECTIVE: To study the surgical outcome and prognostic factors in Ca vulva patients. METHODOLOGY: A retrospective analysis of 19 vulvar cancer patients, surgically treated at a teaching institution of Punjab (2009–2019). RESULTS: Mean age of the patients was 60.95 years. Ulcerative swelling (89.5%) over labia majora (73.7%) was the main presenting symptom. Radical vulvectomy-bilateral IFLN dissection was performed in 74% patients, hemivulvectomy-unilateral IFLN dissection in 21% patients and wide local excision in one patient. Squamous cell carcinoma was detected in all, and one had verrucous carcinoma. Thirty-seven per cent patients had FIGO stage III disease, 31.5% - stage II and 31.5% - stage I. On HPE, 78.57% (11/14) patients had positive nodes and two had ECS. Only 5/9 (55.5%) cases could receive PORT. Seven patients defaulted follow-up. Two developed nodal metastasis, and seven women developed recurrence. One patient with regional recurrence faced demise during RT course. In 10/19 regular follow-up patients, four are alive and disease free, five patients are on palliative chemoradiation, and one is undergoing adjuvant radiotherapy for regional recurrence. Estimated 5-year overall survival is 83.33%. CONCLUSION: Tumour stage, nodal positivity and nodal ECS were poor prognostic factors. Radical surgery-extensive groin node dissection causes significant morbidity; hence, studies evaluating the role of neoadjuvant treatment are needed so as to modify current treatment practices. HPV vaccination as a preventive measure and a thorough and extensive evaluation of patients with suspicious signs in vulvar disease is needed.
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spelling pubmed-102595582023-06-13 Carcinoma vulva: Ten years experience in a teaching institution of North India Goyal, Lajya Devi Kaur, Balpreet Bhalla, Shivali Garg, Pardeep J Family Med Prim Care Original Article INTRODUCTION: Vulvar carcinoma is primarily a disease of post-menopausal women. Surgery is a primary treatment strategy. Chemotherapy and radiotherapy are a part of multimodal therapy. Presently, there is a shift towards neoadjuvant chemotherapy or radiotherapy so as to decrease the surgical morbidities. OBJECTIVE: To study the surgical outcome and prognostic factors in Ca vulva patients. METHODOLOGY: A retrospective analysis of 19 vulvar cancer patients, surgically treated at a teaching institution of Punjab (2009–2019). RESULTS: Mean age of the patients was 60.95 years. Ulcerative swelling (89.5%) over labia majora (73.7%) was the main presenting symptom. Radical vulvectomy-bilateral IFLN dissection was performed in 74% patients, hemivulvectomy-unilateral IFLN dissection in 21% patients and wide local excision in one patient. Squamous cell carcinoma was detected in all, and one had verrucous carcinoma. Thirty-seven per cent patients had FIGO stage III disease, 31.5% - stage II and 31.5% - stage I. On HPE, 78.57% (11/14) patients had positive nodes and two had ECS. Only 5/9 (55.5%) cases could receive PORT. Seven patients defaulted follow-up. Two developed nodal metastasis, and seven women developed recurrence. One patient with regional recurrence faced demise during RT course. In 10/19 regular follow-up patients, four are alive and disease free, five patients are on palliative chemoradiation, and one is undergoing adjuvant radiotherapy for regional recurrence. Estimated 5-year overall survival is 83.33%. CONCLUSION: Tumour stage, nodal positivity and nodal ECS were poor prognostic factors. Radical surgery-extensive groin node dissection causes significant morbidity; hence, studies evaluating the role of neoadjuvant treatment are needed so as to modify current treatment practices. HPV vaccination as a preventive measure and a thorough and extensive evaluation of patients with suspicious signs in vulvar disease is needed. Wolters Kluwer - Medknow 2023-04 2023-04-17 /pmc/articles/PMC10259558/ /pubmed/37312782 http://dx.doi.org/10.4103/jfmpc.jfmpc_1731_22 Text en Copyright: © 2023 Journal of Family Medicine and Primary Care https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Goyal, Lajya Devi
Kaur, Balpreet
Bhalla, Shivali
Garg, Pardeep
Carcinoma vulva: Ten years experience in a teaching institution of North India
title Carcinoma vulva: Ten years experience in a teaching institution of North India
title_full Carcinoma vulva: Ten years experience in a teaching institution of North India
title_fullStr Carcinoma vulva: Ten years experience in a teaching institution of North India
title_full_unstemmed Carcinoma vulva: Ten years experience in a teaching institution of North India
title_short Carcinoma vulva: Ten years experience in a teaching institution of North India
title_sort carcinoma vulva: ten years experience in a teaching institution of north india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10259558/
https://www.ncbi.nlm.nih.gov/pubmed/37312782
http://dx.doi.org/10.4103/jfmpc.jfmpc_1731_22
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