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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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Family Medicine and Primary Care |
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| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=4;spage=654;epage=659;aulast=Goyal |
| _version_ | 1797775584708788224 |
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| author | Lajya Devi Goyal Balpreet Kaur Shivali Bhalla Pardeep Garg |
| author_facet | Lajya Devi Goyal Balpreet Kaur Shivali Bhalla Pardeep Garg |
| author_sort | Lajya Devi Goyal |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-12T22:37:47Z |
| format | Article |
| id | doaj.art-ce44acdc0b9142c0a5e9f3bd773bedd7 |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-03-12T22:37:47Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-ce44acdc0b9142c0a5e9f3bd773bedd72023-07-21T11:37:16ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632023-01-0112465465910.4103/jfmpc.jfmpc_1731_22Carcinoma vulva: Ten years experience in a teaching institution of North IndiaLajya Devi GoyalBalpreet KaurShivali BhallaPardeep GargIntroduction: 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.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=4;spage=654;epage=659;aulast=Goyalradical vulvectomyradiotherapysentinel lymph node biopsysquamous cell carcinoma |
| spellingShingle | Lajya Devi Goyal Balpreet Kaur Shivali Bhalla Pardeep Garg Carcinoma vulva: Ten years experience in a teaching institution of North India Journal of Family Medicine and Primary Care radical vulvectomy radiotherapy sentinel lymph node biopsy squamous cell carcinoma |
| 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 | radical vulvectomy radiotherapy sentinel lymph node biopsy squamous cell carcinoma |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=4;spage=654;epage=659;aulast=Goyal |
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