Surgical Treatment and Reconstruction of Vulvar Carcinoma - Case Series

Öz

Abstract This study aimed to investigate patients treated for early-stage vulvar cancer between January 2016 and January 2019 in the Department of Gynecologic Oncology at the Kartal Dr. Lütfi Kırdar City Hospital. This case series examined the risk factors and surgical outcomes of patients with early-stage vulvar cancer. A total of three patients with vulvar cancer with a mean age of 56 years were included in the study. All cases underwent surgery for stage IB vulvar cancer. All patients were treated with modified radical vulvectomy with bilateral inguinofemoral lymph node dissection and fasciocutaneous flap reconstruction. None of the patients received adjuvant therapy. There was no flap necrosis. In addition, no recurrence or major postoperative complication was observed during the follow-up period. Keywords: Vulvar cancer, Inguinofemoral lymphadenectomy, Modified radical vulvectomy, flap

Anahtar Kelimeler

• Vulvar cancer, Inguinofemoral lymphadenectomy, modified radical vulvectomy, flap

Vulvar Karsinomun Cerrahi Tedavisi ve Rekonstrüksiyonu - Vaka Serisi

Öz

Surgical Treatment and Reconstruction of Vulvar Carcinoma - Case Series Özet Bu çalışmada Kartal Dr. Lütfi Kırdar Şehir Hastanesi Jinekolojik Onkoloji bölümünde Ocak 2016-Ocak 2019 tarihleri arasında erken evre vulva kanseri nedeniyle tedavi edilen hastaların incelenmesi amaçlandı. Bu vaka serisi, erken evre vulvar kanserli hastaların risk faktörlerini ve cerrahi sonuçlarını inceledi. Çalışmaya ortalama yaşları 56 olan vulvar kanserli toplam üç hasta dahil edildi. Tüm olgular evre IB vulva kanseri nedeniyle ameliyat edildi. Tüm hastalara modifiye radikal vulvektomi, bilateral inguinofemoral lenf nodu diseksiyonu ve fasiokutan flep rekonstrüksiyonu uygulandı. Hastaların hiçbiri adjuvan tedavi almamıştı. Flep nekrozu yoktu. Ayrıca takip sürecinde nüks veya majör postoperatif komplikasyon görülmedi. Anahtar Kelimeler: Vulva kanseri, İnguinofemoral lenfadenektomi, Modifiye radikal vulvektomi, flep Abstract This study aimed to investigate patients treated for early-stage vulvar cancer between January 2016 and January 2019 in the Department of Gynecologic Oncology at the Kartal Dr. Lütfi Kırdar City Hospital. This case series examined the risk factors and surgical outcomes of patients with early-stage vulvar cancer. A total of three patients with vulvar cancer with a mean age of 56 years were included in the study. All cases underwent surgery for stage IB vulvar cancer. All patients were treated with modified radical vulvectomy with bilateral inguinofemoral lymph node dissection and fasciocutaneous flap reconstruction. None of the patients received adjuvant therapy. There was no flap necrosis. In addition, no recurrence or major postoperative complication was observed during the follow-up period. Keywords: Vulvar cancer,Inguinofemoral lymphadenectomy, Modified radical vulvectomy, flap

Anahtar Kelimeler

• Vulva kanseri
• İnguinofemoral lenfadenektomi
• Modifiye radikal vulvektomi
• flep

Kaynakça

1. 1. Alkatout I, Schubert M, Garbrecht N, Weigel MT, Jonat W, Mundhenke C. Vulvar cancer: epidemiology, clinical presentation, and management options. Int J Womens Health. 2015;7:305–13. 2. GuntherV,AlkatoutI,LezC,etal.Malignant melanoma of the urethra: a rare histologic subdivision of vulvar cancer with a poor prognosis. Case Rep Obstet Gynecol. 2012;2012:385175.
2. 3. Yutaka Ueda, Takayuki Enomoto, Toshihiro Kimura, Kiyoshi Yoshino, Masami Fujita, Tadashi Kimura, "Two Distinct Pathways to Development of Squamous Cell Carcinoma of the Vulva", Journal of Skin Cancer, vol. 2011, Article ID 951250, 7 pages, 2011.
3. 4. Berek JS, Friedlander M, Hacker NF. Berek and Hacker’s gynecologic oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. Epithelial ovarian, fallopiantube and peritoneal cancer; pp. 443–508.
4. 5. Royal College of Obstetrics and Gynaecology (2014) Guidelines for the diagnosis and management of vulvar carcinoma. British Gynaecological cancer society: Royal College of Obstetrics and Gynaecology
5. 6. Miljanović-Špika I, Madunić MD, Topolovec Z, Kujadin Kenjereš D, Vidosavljević D. Prognostic factors for vulvar cancer. Acta Clin Croat. 2021 Mar;60(1):25-32
6. 7. Cancer Stat Facts: Vulvar Cancer. Available online: https://seer.cancer.gov/statfacts/html/vulva.html (accessed on 21 March 2022).
7. 8. Merlo S. Modern treatment of vulvar cancer. Radiol Oncol. 2020 Sep 22;54(4):371-376.
8. 9. Stroup AM, Harlan LC, Trimble EL. Demographic, clinical and treatment trends among women diagnosed with vulvar cancer in the United States. Gynecol Oncol. 2008;108:577–583.

9. 10. Virarkar M, Vulasala SS, Daoud T, Javadi S, Lall C, Bhosale P. Vulvar Cancer: 2021 Revised FIGO Staging System and the Role of Imaging. Cancers (Basel). 2022 Apr 30;14(9):2264. Olawaiye, AB, Cuello, MA, Rogers, LJ. Cancer of the vulva: 2021 update. Int J Gynecol Obstet. 2021; 155(Suppl. 1): 7– 18.
10. 11. Hacker NF, Barlow E, Morrell S, Tang K. Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival. Cancers (Basel). 2021 Nov 19;13(22):5806. doi: 10.3390/cancers13225806. PMID: 34830958; PMCID: PMC8616189.
11. 12. Lakhwani P, Agarwal P, Mahajan JA, Goel A, Pande P, Mehta S, Kumar K. Surgical Management of Carcinoma Vulva-Case Series and Review of Literature. Indian J Surg Oncol. 2019 Jun;10(2):324-328.
12. 13. Zhang J, Zhang J, Ge J, Su Z, Xiao X, Chen C, Shi F, Wang Y, Zhang J, Liang W. Experience with flap repair after vulvar carcinoma resection: a retrospective observational study of 26 cases. Transl Cancer Res. 2022 Jun;11(6):1740-1749.