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Management of Early-Stage Vulvar Cancer
SIMPLE SUMMARY: Vulvar cancer is a rare gynecological malignancy that affects mainly postmenopausal women. Recently, however, an alarming increase in the rates among young women has been observed due to human papillomavirus infection. The standard treatment for vulvar cancer is surgery with or witho...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9454625/ https://www.ncbi.nlm.nih.gov/pubmed/36077719 http://dx.doi.org/10.3390/cancers14174184 |
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author | Pedrão, Priscila Grecca Guimarães, Yasmin Medeiros Godoy, Luani Rezende Possati-Resende, Júlio César Bovo, Adriane Cristina Andrade, Carlos Eduardo Mattos Cunha Longatto-Filho, Adhemar dos Reis, Ricardo |
author_facet | Pedrão, Priscila Grecca Guimarães, Yasmin Medeiros Godoy, Luani Rezende Possati-Resende, Júlio César Bovo, Adriane Cristina Andrade, Carlos Eduardo Mattos Cunha Longatto-Filho, Adhemar dos Reis, Ricardo |
author_sort | Pedrão, Priscila Grecca |
collection | PubMed |
description | SIMPLE SUMMARY: Vulvar cancer is a rare gynecological malignancy that affects mainly postmenopausal women. Recently, however, an alarming increase in the rates among young women has been observed due to human papillomavirus infection. The standard treatment for vulvar cancer is surgery with or without radiotherapy as adjuvant treatment. In recent decades, sentinel lymph node biopsy has been included as part of the surgical treatment. Thus, our objective was to review and discuss the advances found in the literature about early-stage vulvar cancer. For this, we searched PubMed for publications in the English language. Relevant articles, such as the GROINS-V studies, and the GOG protocols, are presented in this review exhibiting the evolution of early-stage vulvar cancer treatment and the decrease in surgical morbidity rates. ABSTRACT: Vulvar cancer is a rare gynecological malignancy since it represents 4% of all cancers of the female genital tract. The most common histological type is squamous cell carcinoma (90%). This type can be classified into two clinicopathological subtypes according to the etiology. The first subtype is associated with persistent human papillomavirus infection and is usually diagnosed in younger women. The second subtype is associated with lichen sclerosus condition, and in most cases is diagnosed in postmenopausal women. Currently, an increase in first subtype cases has been observed, which raised the concern about associated mortality and treatment morbidity among young women. Vulvar cancer treatment depends on histopathology grade and staging, but surgery with or without radiotherapy as adjuvant treatment is considered the gold standard. In recent decades, sentinel lymph node biopsy has been incorporated as part of the treatment. Therefore, we sought to review and discuss the advances documented in the literature about vulvar cancer focusing on the treatment of early-stage disease. Relevant articles, such as the GROINS-V studies and the GOG protocols, are presented in this review. Additionally, we discuss key points such as the evolution of treatment from invasive surgery with high morbidity, to more conservative approaches without compromising oncologic safety; the role of sentinel lymph node mapping in the initial staging, since it reduces the complications caused by inguinofemoral lymphadenectomy; the recurrences rates, since local recurrence is common and curable, however, groin-associated, or distant recurrences have a poor prognosis; and, finally, the long-term follow-up that is essential for all patients. |
format | Online Article Text |
id | pubmed-9454625 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94546252022-09-09 Management of Early-Stage Vulvar Cancer Pedrão, Priscila Grecca Guimarães, Yasmin Medeiros Godoy, Luani Rezende Possati-Resende, Júlio César Bovo, Adriane Cristina Andrade, Carlos Eduardo Mattos Cunha Longatto-Filho, Adhemar dos Reis, Ricardo Cancers (Basel) Review SIMPLE SUMMARY: Vulvar cancer is a rare gynecological malignancy that affects mainly postmenopausal women. Recently, however, an alarming increase in the rates among young women has been observed due to human papillomavirus infection. The standard treatment for vulvar cancer is surgery with or without radiotherapy as adjuvant treatment. In recent decades, sentinel lymph node biopsy has been included as part of the surgical treatment. Thus, our objective was to review and discuss the advances found in the literature about early-stage vulvar cancer. For this, we searched PubMed for publications in the English language. Relevant articles, such as the GROINS-V studies, and the GOG protocols, are presented in this review exhibiting the evolution of early-stage vulvar cancer treatment and the decrease in surgical morbidity rates. ABSTRACT: Vulvar cancer is a rare gynecological malignancy since it represents 4% of all cancers of the female genital tract. The most common histological type is squamous cell carcinoma (90%). This type can be classified into two clinicopathological subtypes according to the etiology. The first subtype is associated with persistent human papillomavirus infection and is usually diagnosed in younger women. The second subtype is associated with lichen sclerosus condition, and in most cases is diagnosed in postmenopausal women. Currently, an increase in first subtype cases has been observed, which raised the concern about associated mortality and treatment morbidity among young women. Vulvar cancer treatment depends on histopathology grade and staging, but surgery with or without radiotherapy as adjuvant treatment is considered the gold standard. In recent decades, sentinel lymph node biopsy has been incorporated as part of the treatment. Therefore, we sought to review and discuss the advances documented in the literature about vulvar cancer focusing on the treatment of early-stage disease. Relevant articles, such as the GROINS-V studies and the GOG protocols, are presented in this review. Additionally, we discuss key points such as the evolution of treatment from invasive surgery with high morbidity, to more conservative approaches without compromising oncologic safety; the role of sentinel lymph node mapping in the initial staging, since it reduces the complications caused by inguinofemoral lymphadenectomy; the recurrences rates, since local recurrence is common and curable, however, groin-associated, or distant recurrences have a poor prognosis; and, finally, the long-term follow-up that is essential for all patients. MDPI 2022-08-29 /pmc/articles/PMC9454625/ /pubmed/36077719 http://dx.doi.org/10.3390/cancers14174184 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Pedrão, Priscila Grecca Guimarães, Yasmin Medeiros Godoy, Luani Rezende Possati-Resende, Júlio César Bovo, Adriane Cristina Andrade, Carlos Eduardo Mattos Cunha Longatto-Filho, Adhemar dos Reis, Ricardo Management of Early-Stage Vulvar Cancer |
title | Management of Early-Stage Vulvar Cancer |
title_full | Management of Early-Stage Vulvar Cancer |
title_fullStr | Management of Early-Stage Vulvar Cancer |
title_full_unstemmed | Management of Early-Stage Vulvar Cancer |
title_short | Management of Early-Stage Vulvar Cancer |
title_sort | management of early-stage vulvar cancer |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9454625/ https://www.ncbi.nlm.nih.gov/pubmed/36077719 http://dx.doi.org/10.3390/cancers14174184 |
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