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Vulvar carcinoma

J M Anderson1, J R Cassady, D S Shimm

  • 1Department of Radiation Oncology, University of Arizona, Tucson 85724, USA.

International Journal of Radiation Oncology, Biology, Physics
|July 30, 1995
PubMed
Summary
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Radical vulvectomy and radiation therapy show comparable survival rates for vulvar carcinoma. Radiation therapy with conservative surgery is a viable alternative, while wide excision alone has a higher failure rate.

Area of Science:

  • Gynecologic Oncology
  • Radiation Oncology
  • Surgical Oncology

Background:

  • Controversies surround the optimal treatment for vulvar carcinoma.
  • Surgery and radiation therapy are primary treatment modalities.
  • Evaluating institutional experience is crucial for treatment refinement.

Purpose of the Study:

  • To assess the efficacy of surgery and radiation therapy in treating vulvar carcinoma.
  • To compare outcomes of different treatment modalities.
  • To evaluate the role of radiation therapy in vulvar cancer management.

Main Methods:

  • Retrospective review of 47 patients with squamous cell carcinoma of the vulva (1974-1992).
  • Analysis of TNM stage, treatment modality, 5-year local control, and survival.

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  • Kaplan-Meier analysis for survival and local control rates.

    • Main Results:

    • Stage I/II (28 patients): 5-year survival 69%. Stage III (12 patients): 5-year survival 73%.
    • Radical vulvectomy and radiation therapy demonstrated comparable 5-year survival rates (74%).
    • Wide excision alone showed a trend towards poorer survival (51%) and local control (50%).

    Conclusions:

    • Radical vulvectomy provides good locoregional control and survival.
    • Radiation therapy combined with conservative surgery is a supported alternative for vulvar carcinoma.
    • Wide excision alone should be used cautiously due to higher failure rates; further trials on radiation therapy are warranted.