Article Data

  • Views 1203
  • Dowloads 144

Reviews

Open Access

Diagnostic and therapeutic dilemmas in vulvar cancer

  • J. Baltzer1,*,

1Frauenklinik- Klinikum Krefeld, Krefeld, Germany

DOI: 10.12892/ejgo200404405 Vol.25,Issue 4,July 2004 pp.405-410

Published: 10 July 2004

*Corresponding Author(s): J. Baltzer E-mail:

Abstract

Invasive vulvar cancer is rare. The etiology of vulvar cancer is incompletely understood. Human papilloma virus is known to be the major causal factor. The keystep in the diagnosis is punch biopsy with attention to unifocal or multifocal lesions and involvement of adjacent regions. The therapeutic procedure is based mostly on histomorphologic parameters e.g. unifocal/multifocal lesion, localisation, tumor typing/grading, depth of invasion; the goal of these morphologic and morphometric parameters is to reduce radicality in order to avoid postoperative morbidity without jeopardising the chances of cure. This individualization considers treatment options in both the vulvar and the groin.

Keywords

Precancerous lesions; Preventable delay in diagnostics and therapy; Reduced surgical morbidity; Sentinel node concepts without worsening the prognosis

Cite and Share

J. Baltzer. Diagnostic and therapeutic dilemmas in vulvar cancer. European Journal of Gynaecological Oncology. 2004. 25(4);405-410.

References

[1] Wilkinson E.J., Dong-Lin Xie: "Benign diseases of the vulva". In: Kurmann R.J. (ed.). Blaustein's Pathology of the Female Genital Tract". 5th edition, New York, Springer, 2002.

[2] Sturgeon S.R., Sherman M.W.: "Epidemiology: Vulvar intraepithelial neoplasia (VIN) and vulvar cancer". In: Luesley D.M. (ed.) Cancer and Precancer of the Vulva. London, Arnold, 2000.

[3] Singer A., Monaghan J.M.: "Lower genital tract precancer. Colposcopy, pathology and treatment". London, Blackwell Science, 2000.

[4] Beller U., Sideri M., Maisonneuve P., Benedet J.L., Heintz A.P.M., Ngan H.Y.S. et al.: "Carcinoma of the vulva". J. Epidemiol Biostat., FIGO annual report on the results of treatment in gynecological cancer, 24th vol., Oxford, ISIS Medical Media, 2001.

[5] Gross G., Jablonska S., Pfister A., Stegner H.E. (eds.): "Genital Papilloma Virus Infections. Modern Diagnosis and Treatment" Berlin, Springer, 1990.

[6] Kaufman R.H.: "Intraepithelial neoplasia of the vulva". Gynecol. Oneal., 1995, 56, 8.

[7] Friedrich E.G.: "Vulva Disease". 2"" (ed.), Philadelphia, Saunders, 1983.

[8] Baltzer J., Meerpohl H.G., Bahnsen J.: "Praxis der gynakologischen Onkologie,Konzepte for das differenzierte Vorgehen in Diagnostik, Therapie und Nachsorge, 2. aktualisierte Auflage". Stuttgart, Thieme, 2000.

[9] Wilkinson E.J.: "Superficially invasive carcinoma of the vulva". In: Wilkinson E.J.: (ed.). "Pathology of the Yulvar and Vagina". New York, Churchill, Livingstone, 1987

[10] Rutledge F., Smith P.J., Franklin E.W.: "Carcinoma of the vulva". Am. J. Obstet. Gynecol., 1970, 106, 1117.

[11] Van der Yelden J.: "Surgery in the primary management of vulvar cancer". In: Luesly D.M. (ed.). "Cancer and Precancer of the Vulva". London, Arnold, 2000.

[12] Hacker N.S.: "Vulva cancer". In: Berek J.S., Hacker N.S. (eds.): "Practical Gynecologic Oncology". Baltimore, Williams and Wilkins, 1994.

[13] Monaghan J.M.: "Vulva carcinoma". In: Hirsch H.A., Kaser 0., Ikle F.A. (eds.): "Atlas der gynakologischen operationen". Stuttgart, Thieme, 1995.

[14] Klippers V., Bender H.G.: "Spezielle Gynakologische Onkologie". In: Bender H.G. (4" edition), Miinchen, Urban & Fischer, 2001.

[15] Sliutz G., Reinthaller A., Lantzsch T., Mende T., Sinzinger H., Kainz C., Koelbel H.: "Lymphatic mapping of sentinel nodes in early vulvar cancer". Gynecol. Oneal., 2002, 84, 449

[16] Molpus K.L., Kelley M.C., Johnson J.E., Martin W.H., Jones H.W. Ill: "Sentinel lymph node detection and microstaging in vulva carcinoma". J. Reprod. Med., 2001, 46, 863.

[17] Puig-Tintory L.M., Ordi J., Vidall-Sicart S., Lejarcegui J.A., Tome A., Pahisa J., Iglesias X.: "Further data on the usefulness of sentinel lymphnode identfication and ultrastaging in vulva squamous cell carcinoma". Gynecol. Oneal., 2003, 88, 29.

[18] Jhingran A., Eifel P.: "Role of radiotherapy in the management of vulvar cancer". In: Luesly D.M. (ed.). Cancer and Precancer of the Vulva, Oxford, Arnold, 2000.

[19] Eifel P.J.: "Vulvar carcinoma: radiotherapy or surgery for the lymphatics?". Front. Radiat. Ther. Oneal., 1994, 28, 218.

[20] Faul C.M., Mirmov D., Huang Q.: "Adjuvant radiation for vulvar carcinoma: Improved local control". Int. Radiat. Oneal. Biol. Phys., 1997, 38, 381.

[21] Barke A., Frommhold H.: "Radiotherapie des Vulvakarzinoms". Der Onkologe, 2000, 6, 1061.

[22] Busch M., Wagener B., Schaffer M., Duhmke E.: "Long term impact of postoperative radiotherapy in carcinoma of the vulvar FIGO I/II". Int. J. Radiat. Oneal. Biol. Phys., 2000, 48, 213.

[23] Lupi G.,R aspagliesi F.,Z ucali R.: "Combined preoperative chemo-radio therapy followed by radical surgery in locally advanced vulvar carcinoma. A pilot study". Cancer, 1996, 77, 1472.

[24] Moore D.H., T homas G.M., Montana E.S.: "Preoperative chemo radiation for advanced vulvar cancer: A phase II-study of the gynecologic oncology group". Int. J. Radiat. Oneal. Biol. Phys., 1998, 42, 79.

[25] Han S.C., Kim D.H., Higgins S.A., Carcangiu M.L.: "Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva". Int. J. Radiat. Oneal. Biol. Phys., 2000, 47, 1235.

Submission Turnaround Time

Top