Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas

Journal Article · Thu Feb 01 04:00:00 EST 1990 · Gynecologic Oncology; (USA)

DOI:https://doi.org/10.1016/0090-8258(90)90169-L· OSTI ID:7026083

Rotmensch, J; Rubin, S J; Sutton, H G; Javaheri, G; Halpern, H J; Schwartz, J L; Stewart, M; Weichselbaum, R R; Herbst, A L ^[1]

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1. Univ. of Chicago, IL (USA)

A therapeutic alternative to exenteration for large locally advanced vulvar carcinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.

• OSTI ID: 7026083
• Journal Information: Gynecologic Oncology; (USA), Journal Name: Gynecologic Oncology; (USA) Vol. 36:2; ISSN 0090-8258; ISSN GYNOA
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARCINOMAS
DISEASES
DOSES
FEMALE GENITALS
LYMPH NODES
LYMPHATIC SYSTEM
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
SURGERY
SURVIVAL CURVES
THERAPY