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1. Schmidt M, Fan Z: Protection against chemotherapy-induced cytotoxicity by cyclin-dependent kinase inhibitors (CKI) in CKI-responsive cells compared with CKI-unresponsive cells. Oncogene; 2001 Sep 27;20(43):6164-71
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  • [Title] Protection against chemotherapy-induced cytotoxicity by cyclin-dependent kinase inhibitors (CKI) in CKI-responsive cells compared with CKI-unresponsive cells.
  • Inactivation of the retinoblastoma (Rb) protein caused by gene mutation, association with oncoproteins from small DNA viruses, mutational inactivation of p16(Ink4a), or overexpression of cyclin D is a common feature of many human cancer cells and is causally associated with the aberrant proliferation control of cancer cells; whereas normal cells maintain an integrated cell cycle machinery and are subject to cell cycle checkpoint control by cyclin-dependent kinase (CDK) inhibitors (CKIs).
  • To determine whether this difference can be translated into a therapeutic advantage to protect normal cells from adverse cytotoxicity caused by chemotherapy, we established cell model systems for ecdysone-inducible expression of p16(Ink4a), p21(Waf1), and p27(Kip1) in one CKI-responsive cell line (A431 human vulvar epidermoid carcinoma cells with functional Rb) and one CKI-unresponsive cell line (SiHa human cervical cancer cells with nonfunctional Rb).
  • Expression of p16(Ink4a), p21(Waf1), or p27(Kip1) in both SiHa and A431 cells strongly inhibited CDK2 activity, indicating functional expression of the CDK inhibitors in both cell lines.
  • However, only in A431 cells did expression of p16(Ink4a), p21(Waf1), or p27(Kip1) cause Rb dephosphorylation, arrest cell cycle traversal, and potently inhibit cell proliferation.
  • Induction of p16(Ink4a), p21(Waf1), or p27(Kip1) in SiHa cells failed to cause Rb dephosphorylation or to arrest cell cycle traversal, and such induction only minimally inhibited cell proliferation.
  • We then compared the chemosensitivity of clones derived from these two cell lines when the CKIs were and were not induced.
  • Our results support a novel chemotherapy strategy for treating patients with Rb pathway-impaired cancers by concurrent administration of chemotherapy with CKIs as chemoprotective agents for normal cells.
  • [MeSH-major] Cell Cycle Proteins / metabolism. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Cyclins / metabolism. Enzyme Inhibitors / pharmacology. Tumor Suppressor Proteins
  • [MeSH-minor] Cell Division. Cisplatin / pharmacology. Coloring Agents / pharmacology. Cyclin-Dependent Kinase Inhibitor p21. Cyclin-Dependent Kinase Inhibitor p27. DNA Mutational Analysis. DNA, Complementary / metabolism. Dose-Response Relationship, Drug. Ecdysone / genetics. Flow Cytometry. Humans. Immunoblotting. Mutation. Paclitaxel / pharmacology. Phosphorylation. Promoter Regions, Genetic. Retinoblastoma Protein / metabolism. Tetrazolium Salts / pharmacology. Thiazoles / pharmacology. Tumor Cells, Cultured

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  • (PMID = 11593424.001).
  • [ISSN] 0950-9232
  • [Journal-full-title] Oncogene
  • [ISO-abbreviation] Oncogene
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 16672
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / CDKN1A protein, human; 0 / Cell Cycle Proteins; 0 / Coloring Agents; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / Cyclin-Dependent Kinase Inhibitor p21; 0 / Cyclins; 0 / DNA, Complementary; 0 / Enzyme Inhibitors; 0 / Retinoblastoma Protein; 0 / Tetrazolium Salts; 0 / Thiazoles; 0 / Tumor Suppressor Proteins; 147604-94-2 / Cyclin-Dependent Kinase Inhibitor p27; 298-93-1 / thiazolyl blue; 3604-87-3 / Ecdysone; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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2. Raitanen M, Rantanen V, Kulmala J, Helenius H, Grénman R, Grénman S: Supra-additive effect with concurrent paclitaxel and cisplatin in vulvar squamous cell carcinoma in vitro. Int J Cancer; 2002 Jul 10;100(2):238-43
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  • [Title] Supra-additive effect with concurrent paclitaxel and cisplatin in vulvar squamous cell carcinoma in vitro.
  • The effect of concurrent paclitaxel and cisplatin was tested in vitro in 5 vulvar squamous cell carcinoma (SCC) cell lines (UM-SCV-1A, -2, -4 and -7 and UT-SCV-3).
  • These drug concentrations are clinically achievable.
  • The type of interaction was determined by comparing the AUC ratio of the 2 drugs with the survival fraction (SF) of paclitaxel alone.
  • With all cell lines tested the growth-inhibitory effect of simultaneous paclitaxel and cisplatin was at least additive.
  • The effect of the tested combination on the UM-SCV-1A and UT-SCV-3 cell lines was clearly supra-additive with all paclitaxel concentrations tested, and the UM-SCV-4 and UM-SCV-7 cell lines exhibited a supra-additive effect with increasing paclitaxel concentrations.
  • The degree of supra-additivity was dose-dependent in the UM-SCV-7 cell line with increasing synergy at higher paclitaxel doses.
  • In the current study the combination of paclitaxel and cisplatin had a clear additive or supra-additive cytotoxic effect on the vulvar SCC cell lines, and it has been successfully used in other gynecologic malignancies; therefore concurrent paclitaxel and cisplatin also deserves further testing in clinical settings in advanced-stage vulvar carcinoma, which has a poor prognosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Cell Division / drug effects. Cell Survival / drug effects. Cisplatin / administration & dosage. Dose-Response Relationship, Drug. Drug Resistance, Neoplasm. Drug Synergism. Female. Humans. Paclitaxel / administration & dosage. Tumor Cells, Cultured / drug effects. Tumor Stem Cell Assay

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • (PMID = 12115575.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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3. Raitanen M, Rantanen V, Kulmala J, Pulkkinen J, Klemi P, Grénman S, Grénman R: Paclitaxel combined with fractionated radiation in vitro: a study with vulvar squamous cell carcinoma cell lines. Int J Cancer; 2002 Feb 20;97(6):853-7
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  • [Title] Paclitaxel combined with fractionated radiation in vitro: a study with vulvar squamous cell carcinoma cell lines.
  • Concurrent paclitaxel and radiation has given promising results in the treatment of a variety of solid tumors.
  • We wanted to test the efficacy of this combination for vulvar carcinoma, which currently has a poor outcome in advanced stages.
  • The radiation sensitivity, sublethal damage repair (SLDR) capacity and effect of paclitaxel during fractionated radiation were assessed in our study on 7 vulvar inherently radioresistant squamous cell carcinoma (SCC) cell lines.
  • AUC ratios between single-dose radiation and fractionated radiation with or without paclitaxel were used to determine the SLDR of the cell lines and the effect of paclitaxel on it.
  • Seven currently tested vulvar SCC cell lines were found to have a limited capacity of repairing sublethal damage (SLD).
  • The effect of concurrent radiation and paclitaxel was clearly additive when the radiation dose was fractionated in most of the cell lines.
  • In addition, 2 of the cell lines having SLDR exhibited a trend toward losing the repair capacity when paclitaxel was present during the irradiation.
  • In addition, the survival curve of the UM-SCV-1A cell line gave the impression of a true paclitaxel effect on SLDR.
  • Paclitaxel used concurrently with fractionated radiation showed effectiveness on vulvar carcinoma.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Paclitaxel / therapeutic use. Radiation-Sensitizing Agents / therapeutic use. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Cell Survival / drug effects. Cell Survival / radiation effects. Combined Modality Therapy. Dose Fractionation. Female. Humans. In Vitro Techniques. Radiotherapy Dosage. Tumor Cells, Cultured. Tumor Stem Cell Assay

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  • [Copyright] Copyright 2001 Wiley-Liss, Inc.
  • (PMID = 11857367.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; P88XT4IS4D / Paclitaxel
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4. Bifulco G, Mandato VD, Piccoli R, Giampaolino P, Mignogna C, Mignogna MD, Costagliola L, Nappi C: Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus. BMC Cancer; 2010;10:324
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  • [Title] Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus.
  • Here, we report the first case of a woman affected with SLE presenting with early invasive squamous cell carcinoma (SCC) arising from Pemphigus Vulgaris of the vulva.
  • CASE PRESENTATION: A 27-year-old Caucasian woman was admitted to our Gynaecology Unit for bleeding vegetant lesions of the vulva.
  • Biopsy showed concomitant PV and vulvar intraepithelial neoplasia (VIN) grade 3.
  • One month later a new biopsy revealed progression from VIN 3 to early SCC.
  • Despite chemotherapy, no remission of disease was observed.
  • She died six months after diagnosis CONCLUSION: Our case underlines PV as another chronic inflammatory disease of the lower genital tract predisposing to VIN-SCC.
  • [MeSH-major] Carcinoma in Situ / etiology. Carcinoma, Squamous Cell / etiology. Lupus Erythematosus, Systemic / complications. Pemphigus / complications. Vulvar Diseases / complications. Vulvar Neoplasms / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Disease Progression. Fatal Outcome. Female. Humans. Neoplasm Invasiveness. Neoplasm Staging. Time Factors


5. Ghaemmaghami F, Modares M, Behtash N, Moosavi AZ: Multiple, disseminated cutaneous metastases of vulvar squamous cell carcinoma. Int J Gynecol Cancer; 2004 Mar-Apr;14(2):384-7
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  • [Title] Multiple, disseminated cutaneous metastases of vulvar squamous cell carcinoma.
  • Cutaneous metastases of vulvar carcinoma are extremely rare and have been reported in six patients so far.
  • Our patient, who is the seventh one, is a 38-year-old woman with a history of diabetes mellitus.
  • After detecting stage III squamous cell carcinoma of the vulva, she underwent radical vulvectomy and bilateral inguinal lymphadenectomy.
  • For her palliation, some chemotherapy drugs were prescribed.
  • She is on her sixth chemotherapy cycle, but these skin lesions are somewhat a preterminal event and there is no well-established treatment for this phase of disease.
  • [MeSH-major] Carcinoma, Squamous Cell / diagnosis. Skin Neoplasms / diagnosis. Vulvar Neoplasms / diagnosis
  • [MeSH-minor] Adult. Buttocks. Combined Modality Therapy. Diagnosis, Differential. Fatal Outcome. Female. Humans. Neoplasm Metastasis. Neoplasm Staging

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  • (PMID = 15086744.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 19
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6. Vázquez JP, Cobo SL, Antón FM, Asado AC, Vidart JA, Coronado P, Díaz-Rubio E: Brain metastasis and carcinomatous meningitis from vulvar squamous cell carcinoma: case report. Eur J Gynaecol Oncol; 2007;28(2):152-4
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  • [Title] Brain metastasis and carcinomatous meningitis from vulvar squamous cell carcinoma: case report.
  • CASE: A 74-year-old woman was diagnosed with locally advanced vulvar squamous carcinoma.
  • Initial therapy consisted of multiagent chemotherapy and vulvar, pelvis and groin irradiation.
  • The patient subsequently developed widely spread metastatic disease including brain and meningeal metastases.
  • CONCLUSION: The rising incidence of central nervous system metastasis in the last two decades is probably associated with treatment-related improvement in life expectancy.
  • To our knowledge, this is the first case reported of brain metastases and meningeal carcinomatosis associated with vulvar squamous cell carcinoma.
  • [MeSH-major] Brain Neoplasms / secondary. Carcinoma, Squamous Cell / secondary. Meningeal Neoplasms / secondary. Vulvar Neoplasms / pathology
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans

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  • (PMID = 17479684.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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7. Carvalho JP, Dias ML, Carvalho FM, Del Pilar Estevez Diz M, Petito JW: Squamous cell vulvar carcinoma associated with Fanconi's anemia: a case report. Int J Gynecol Cancer; 2002 Mar-Apr;12(2):220-2
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  • [Title] Squamous cell vulvar carcinoma associated with Fanconi's anemia: a case report.
  • Fanconi's anemia (FA) is a rare autosomal recessive syndrome associated with a strong predisposition to cancer, particularly squamous cell carcinoma (SCC) of various organs.
  • We present a 14-year-old black girl with an advanced squamous cell vulvar carcinoma treated with cisplatin chemotherapy plus radiation therapy.
  • Vulvar carcinoma is a very rare condition in teenagers, but the association of Fanconi's anemia and SCC of many sites is common.
  • Vulvar carcinoma when associated with Fanconi's anemia is a great treatment challenge.
  • [MeSH-major] Carcinoma, Squamous Cell / etiology. Fanconi Anemia / complications. Vulvar Neoplasms / etiology
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Candidiasis / complications. Cisplatin / therapeutic use. Combined Modality Therapy. Fatal Outcome. Female. Filgrastim. Granulocyte Colony-Stimulating Factor / therapeutic use. Humans. Opportunistic Infections / complications. Recombinant Proteins

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  • (PMID = 11975685.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Recombinant Proteins; 143011-72-7 / Granulocyte Colony-Stimulating Factor; PVI5M0M1GW / Filgrastim; Q20Q21Q62J / Cisplatin
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8. Moore DH: Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: Are two therapies better than one? Gynecol Oncol; 2009 Jun;113(3):379-83
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  • [Title] Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: Are two therapies better than one?
  • As gynecologic surgeons garnered a better understanding of various clinical-pathological prognostic factors, there evolved a number of modifications in the surgical approach allowing for more individualized therapy with less morbidity, while still retaining the curative potential of the radical vulvectomy operation.
  • The incorporation of radiation therapy and eventually chemotherapy in the primary treatment of vulva cancer also represents a slow evolution in clinical management.
  • The addition of chemotherapy concurrent to radiation therapy for the treatment of vulvar carcinoma was heavily influenced by advances in the treatment of cervical cancer, and squamous cell carcinoma of the anal canal.
  • On the basis of many good phase II studies but no randomized controlled trials in the disease, chemoradiation therapy is now inherent to the clinical management of vulvar carcinoma.
  • The rarity of vulva cancer precludes prospective randomized clinical trials in the absence of international collaboration.
  • Nonetheless, patients with locally advanced vulva cancer have derived considerable benefit from chemoradiation studies in other related tumor sites, and will continue to do so in the future.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Female. Humans

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  • (PMID = 19232700.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 77
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9. Mulayim N, Foster Silver D, Schwartz PE, Higgins S: Chemoradiation with 5-fluorouracil and mitomycin C in the treatment of vulvar squamous cell carcinoma. Gynecol Oncol; 2004 Jun;93(3):659-66
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  • [Title] Chemoradiation with 5-fluorouracil and mitomycin C in the treatment of vulvar squamous cell carcinoma.
  • OBJECTIVE: To investigate the acute and late toxicities associated with the use of chemoradiation therapy (CRT) with 5-fluorouracil (5-FU) and mitomycin C or mitomycin C alone for primary, adjuvant, and salvage therapy for vulvar cancer.
  • In three patients, life-threatening neutropenic sepsis developed after the second cycle of chemotherapy.
  • In four patients, the second cycle of chemotherapy was cancelled because of severe toxicity associated with the first cycle.
  • One patient had grade 4 skin toxicity in the vulvar-perineal area.
  • Skin toxicity necessitated the interruption of CRT in nine patients at a median dose of 32.4 Gy (range: 16.2-48 Gy).
  • One patient developed bowel perforation and colovaginal fistula 1.5 years after completion of CRT.
  • CONCLUSION: Chemoradiation therapy utilizing 5-FU and mitomycin C or mitomycin C alone in the treatment of vulvar cancer can be associated with a high incidence of morbidity and mortality.
  • Strict attention to indications for treatment interruptions or chemotherapy dose adjustments is obligatory for safe delivery of CRT to these patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Mitomycin / adverse effects. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Neoplasm Staging. Radiotherapy / adverse effects. Radiotherapy, Adjuvant. Salvage Therapy / adverse effects

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  • (PMID = 15196861.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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10. Tartaglia E, Messalli EM, Di Serio M, Rotondi M, Mainini G, Di Serio C: A new approach to vulvar squamous cell carcinoma: two-year follow-up of a case report. Eur J Gynaecol Oncol; 2007;28(1):51-3
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  • [Title] A new approach to vulvar squamous cell carcinoma: two-year follow-up of a case report.
  • BACKGROUND: Vulvar carcinoma is relatively rare gynaecologic malignancy.
  • The most prevalent vulvar cancer is squamous cell carcinoma.
  • The sentinel lymph node "concept" is attractive in vulvar cancer because it has the potential to avoid a radical vulvectomy associated with uni- or bilateral inguinofemoral lymphadenectomy and, thus, to avoid the morbidity associated with formal groin dissection.
  • CASE REPORT: A case of an 88-year-old woman with advanced local vulvar cancer is presented.
  • A study of the inguinal-femoral lymph nodes was also conducted with intraoperative vital blue dye peritumoral injection and as the sentinel node was found to be negative for malignant metastasis, a radical vulvectomy without bilateral inguinofemoral lymphadenectomy and without additional treatment (chemotherapy and/or radiotherapy) was performed.
  • CONCLUSION: The sentinel lymph node procedure allows a less aggressive treatment to be carried out in patients with invasive vulvar cancer thus reducing the complications and morbidity of treatment.
  • [MeSH-major] Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / surgery. Vulvar Neoplasms / diagnosis. Vulvar Neoplasms / surgery
  • [MeSH-minor] Aged, 80 and over. Female. Follow-Up Studies. Humans. Lymph Nodes / radionuclide imaging. Sensitivity and Specificity. Sentinel Lymph Node Biopsy. Technetium Tc 99m Aggregated Albumin. Treatment Outcome

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  • (PMID = 17375708.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Technetium Tc 99m Aggregated Albumin
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11. Khouchani M, Benchakroun N, Tahri A, Tawfiq N, Jouhadi H, Acharki A, Sahraoui S, Belaabidia B, Benider A: [Breast metastasis from vulvar carcinoma: case report and review of literature]. Cancer Radiother; 2008 Mar;12(2):120-5
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  • [Title] [Breast metastasis from vulvar carcinoma: case report and review of literature].
  • [Transliterated title] Métastase intramammaire d'un cancer vulvaire: à propos d'un cas avec revue de la littérature.
  • The breast metastases resulting of vulvar carcinoma are very rare, and represent exceptionally the first manifestation of the disease.
  • We report the case of a 42 year-old patient who underwent a treatment because of vulvar epidermoid carcinoma, right away metastatic at the level of the inguinal ganglia.
  • The treatment consisted in a total vulvectomy with bilateral ganglial curretage, followed by external radiotherapy about the perineum and the inguinal ganglia.
  • Three months after the end of her treatment, the patient presented with a nodula on the left outer breast with features of malignancy noticed by clinic and mammographic examination.
  • The histologic study of the mammary biopsy showed epidermoid carcinoma of likely metastatic origin.
  • A left Patey has been realized and confirmed the metastatic localization of epidermoid carcinoma with axillary ganglial metastasis (2N+/-7).
  • Besides, this patient presented a right cervical ganglial parcel that the biopsy showed a metastatic localization of a vulvar carcinoma.
  • A palliative chemotherapy type cyclophosphamid, adriblastin, cisplatine (CAP) has been admistrated during three cycles spaced out three weeks.
  • We present this case because its rarety and to show the possibility of metastasis at the level of breast due to vulvar cancer.
  • The clinicians must remember this possible tropism of the vulvar cancer for the breast, not only during the supervision and the complete examination as regards the disease spreading but also when the affection revealed unknown primary tumor.
  • In this stage, the treatment is unfortunately palliative, the survival until a year is not more than 20%.
  • [MeSH-major] Breast Neoplasms / secondary. Carcinoma, Squamous Cell / secondary. Vulvar Neoplasms / pathology

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  • (PMID = 18343704.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 31
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12. Richard SD, Krivak TC, Beriwal S, Zorn KK: Recurrent metastatic vulvar carcinoma treated with cisplatin plus cetuximab. Int J Gynecol Cancer; 2008 Sep-Oct;18(5):1132-5
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  • [Title] Recurrent metastatic vulvar carcinoma treated with cisplatin plus cetuximab.
  • Recurrent vulvar carcinoma with metastasis has few effective treatment options, which are mainly directed toward palliation of symptoms.
  • A 70-year-old woman was originally treated in 1999 for vulvar squamous cell carcinoma (SCC) with radical vulvectomy and bilateral inguinofemoral groin dissection.
  • She represented in 2005 with a new lesion distinct from the margin of her first disease occurrence.
  • Although treatment of this area included surgical resection and chemoradiation, she recurred 3 months later.
  • She was treated with palliative radiation therapy (RT) and a cetuximab plus cisplatin chemotherapy protocol.
  • Few treatment options exist for recurrent metastatic vulvar carcinoma.
  • The partial response experienced in our patient suggests its potential use in women with recurrent or metastatic vulvar carcinoma.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / therapeutic use. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / pathology
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Humanized. Cetuximab. Female. Humans. Neoplasm Metastasis / drug therapy. Neoplasm Metastasis / pathology. Neoplasm Metastasis / radiography. Recurrence. Tomography, X-Ray Computed

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  • (PMID = 18021214.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; PQX0D8J21J / Cetuximab; Q20Q21Q62J / Cisplatin
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13. Akl A, Akl M, Boike G, Hebert J, Graham J: Preliminary results of chemoradiation as a primary treatment for vulvar carcinoma. Int J Radiat Oncol Biol Phys; 2000 Sep 1;48(2):415-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preliminary results of chemoradiation as a primary treatment for vulvar carcinoma.
  • PURPOSE: To assess the role of chemoradiation as a primary treatment for vulvar carcinoma.
  • METHODS AND MATERIALS: Between December 1989 and August 1997, there were 14 patients with the diagnosis of squamous cell carcinoma of the vulva.
  • All patients had biopsy prior to treatment, and were treated with chemoradiation.
  • Radiation was administered to the vulva only.
  • Surgical biopsies from the vulva and inguinal nodal dissection were done 4-6 weeks after radiation treatment.
  • All patients were followed for evaluation of response and clinical detection of recurrence.
  • RESULTS: All 12 patients showed complete response to the treatment.
  • Only 1 patient (8.3%) developed local recurrence at 3 months posttreatment.
  • Another patient (8.3%) developed nodal recurrence at 30 months posttreatment.
  • Both patients were salvaged by surgical treatment and remained disease free.
  • The majority of patients developed mild-to-moderate complications due to chemoradiation.
  • These were well tolerated and responded to medical treatment.
  • None of the patients developed late complications to chemoradiation treatment.
  • CONCLUSIONS: Chemoradiation is an effective primary treatment for vulvar carcinoma as shown by these successfully managed cases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Middle Aged. Mitomycin / administration & dosage. Neoplasm Staging

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  • (PMID = 10974455.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
  • [Number-of-references] 30
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14. Rahadiani N, Ikeda J, Makino T, Tian T, Qiu Y, Mamat S, Wang Y, Doki Y, Aozasa K, Morii E: Tumorigenic role of podoplanin in esophageal squamous-cell carcinoma. Ann Surg Oncol; 2010 May;17(5):1311-23
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  • [Title] Tumorigenic role of podoplanin in esophageal squamous-cell carcinoma.
  • BACKGROUND: Podoplanin, a mucin-type transmembrane glycoprotein, is thought to be one of the cancer stem cell markers for squamous-cell carcinoma of the vulva.
  • The objectives of the present study were to examine the role of podoplanin in esophageal squamous-cell carcinoma (ESCC).
  • METHODS: Expression of podoplanin was examined immunohistochemically in 61 cases of ESCC that had not been treated with chemotherapy or radiotherapy before surgery.
  • Because cancer stem-cell quantities have been reported to increase with chemotherapy and radiotherapy, cases in patients who did not receive such prior therapies were included in this study.
  • The effects of podoplanin on the behavior of cancer cells were evaluated in ESCC cell lines in which podoplanin expression was knocked down.
  • RESULTS: To examine whether podoplanin could be used as a cancer stem cell marker for ESCC, podoplanin-positive and podoplanin-negative fractions were sorted separately from the ESCC cell line and cultured.
  • When podoplanin expression was knocked down, ESCC cell lines became vulnerable to anticancer drugs and showed defective invasion and tumorigenic activities.
  • Podoplanin-high cases were correlated with T category, stage of disease, lymphatic and vascular invasion, recurrence, and prognosis of patients.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Carcinoma, Squamous Cell / metabolism. Esophageal Neoplasms / metabolism. Membrane Glycoproteins / physiology
  • [MeSH-minor] Aged. Aged, 80 and over. Animals. Antineoplastic Agents / pharmacology. Apoptosis / drug effects. Blotting, Western. Cell Movement. Cell Proliferation / drug effects. Colony-Forming Units Assay. Female. Flow Cytometry. Gene Silencing / physiology. Humans. Immunoenzyme Techniques. Male. Mice. Mice, Inbred NOD. Mice, SCID. Middle Aged. RNA, Messenger / genetics. RNA, Messenger / metabolism. RNA, Small Interfering / pharmacology. Reverse Transcriptase Polymerase Chain Reaction. Survival Rate. Tissue Array Analysis. Topotecan / pharmacology. Treatment Outcome. Tumor Cells, Cultured. Xenograft Model Antitumor Assays

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  • (PMID = 20066519.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Membrane Glycoproteins; 0 / PDPN protein, human; 0 / RNA, Messenger; 0 / RNA, Small Interfering; 7M7YKX2N15 / Topotecan
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15. van Doorn HC, Ansink A, Verhaar-Langereis M, Stalpers L: Neoadjuvant chemoradiation for advanced primary vulvar cancer. Cochrane Database Syst Rev; 2006;(3):CD003752
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  • [Title] Neoadjuvant chemoradiation for advanced primary vulvar cancer.
  • BACKGROUND: In advanced stage primary vulvar cancer, treatment is tailored to individual patient needs.
  • Combined treatment modalities have been developed, using chemotherapy, radiotherapy and surgery.
  • OBJECTIVES: To determine whether the combined treatment strategy using concurrent neoadjuvant chemoradiation therapy followed by surgery is effective and safe in vulvar cancer patients with advanced primary disease.
  • Main outcomes of interest were: types of surgical intervention following chemoradiation and survival, recurrence and complication rates.
  • SELECTION CRITERIA: Studies of curative treatment of patients with advanced, primary squamous cell carcinoma of the vulva were included.
  • Treatment included concurrent radiotherapy and chemotherapy, followed by surgery.
  • MAIN RESULTS: Chemotherapy was given uniformly within each of the five selected studies.
  • A total of 27 to 85% of participants died due to treatment related causes or disease.
  • However, complications of treatment are considerable and information on the effects of quality of life (QOL) is not available.
  • Furthermore, treatment results of the respective studies diverge considerably.
  • In patients with large tumours that can only be treated with anterior and/or posterior exenteration complications of neoadjuvant therapy might outweigh complications of exenterative surgery.
  • With the current knowledge neoadjuvant therapy is not justified in patients with tumours that can be adequately treated with radical vulvectomy and bilateral groin node dissection alone.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Female. Humans. Neoadjuvant Therapy

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  • [UpdateIn] Cochrane Database Syst Rev. 2011;(4):CD003752 [21491387.001]
  • (PMID = 16856018.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 41
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16. Santegoets LA, Helmerhorst TJ, van der Meijden WI: A retrospective study of 95 women with a clinical diagnosis of genital lichen planus. J Low Genit Tract Dis; 2010 Oct;14(4):323-8
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  • [Title] A retrospective study of 95 women with a clinical diagnosis of genital lichen planus.
  • OBJECTIVE: The aim of this retrospective clinical study was to evaluate clinical features, histopathology, treatment regimen, and follow-up in 95 patients with genital lichen planus.
  • MATERIALS AND METHODS: We retrospectively analyzed data of 95 women diagnosed with genital lichen planus and visiting the vulvar clinic at Erasmus MC, Rotterdam, the Netherlands.
  • RESULTS: All patients were symptomatic, most often complaining of vulvar soreness and burning (31.6%).
  • Treatment usually consisted of potent topical corticosteroids.
  • Seventeen women (17.9%) were referred to the gynecology department for additional surgical treatment.
  • In two of them, a vulvar squamous cell carcinoma was detected, followed by radical surgery.
  • CONCLUSIONS: In cases with vulvar soreness and burning, sharply demarcated erythematous vulvar lesions, and the concomitant presence of oral lesions, the diagnosis of lichen planus should be considered and treatment must be initiated accordingly, even when histopathology is discordant.
  • [MeSH-major] Lichen Planus / drug therapy. Lichen Planus / pathology. Vulvar Diseases / drug therapy. Vulvar Diseases / pathology
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Adult. Aged. Aged, 80 and over. Anti-Inflammatory Agents / therapeutic use. Female. Histocytochemistry. Humans. Middle Aged. Mouth Mucosa / pathology. Netherlands. Retrospective Studies. Treatment Outcome

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  • (PMID = 20885160.001).
  • [ISSN] 1526-0976
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Anti-Inflammatory Agents
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17. Raffetto N, Tombolini V, Santarelli M, Valeriani M, Galla DA, Enrici RM: Radiotherapy alone and chemoirradiation in recurrent squamous cell carcinoma of the vulva. Anticancer Res; 2003 May-Jun;23(3C):3105-8
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  • [Title] Radiotherapy alone and chemoirradiation in recurrent squamous cell carcinoma of the vulva.
  • AIM: To evaluate the role of radiotherapy alone or combined with chemotherapy in the treatment of recurrent vulvar cancer, emphasising the prognostic factors and outcomes.
  • MATERIALS AND METHODS: Twenty women with loco-regional recurrence of vulvar carcinoma were retrospectively reviewed.
  • Eleven patients were managed with a combination of chemotherapy and radiotherapy, seven out of these with concomitant radio-chemotherapy and four with neo-adjuvant chemotherapy.
  • The total dose of radiation therapy ranged from 30 Gy to 70 Gy.
  • Patients with one site of recurrence and size of lesion < or = 3 cm were long survivors and disease-free at 5 years; all these women received a total dose of radiation therapy > or = 6480 cGy.
  • CONCLUSION: We emphasize the importance of the number, site and diameter of recurrences as prognostic indicators; the outcomes of these patients were also affected by the total dose of radiation therapy.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / radiotherapy. Retrospective Studies. Treatment Outcome

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  • (PMID = 12926170.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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18. Seward SM, Richardson DL, Leon ME, Zhao W, Cohn DE, Hitchcock CL: Metastatic squamous cell carcinoma of the vulva to the lung confirmed with allelotyping. Int J Gynecol Pathol; 2009 Sep;28(5):497-501
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  • [Title] Metastatic squamous cell carcinoma of the vulva to the lung confirmed with allelotyping.
  • A squamous-cell carcinoma (SCC) of the lung can be indistinguishable from metastatic SCC of gynecologic origin using common histopathologic techniques; however, establishing tumor origin can be clinically relevant.
  • A patient with a Bartholin gland SCC was found to also have a pulmonary SCC, concerning for metastasis versus synchronous pulmonary primary.
  • Allelotyping for loss of heterozygosity established the pulmonary lesion as a rare event of vulvar pulmonary metastasis.
  • The patient received palliative chemotherapy instead of curative treatment.
  • [MeSH-major] Carcinoma, Squamous Cell / genetics. Carcinoma, Squamous Cell / secondary. Lung Neoplasms / genetics. Lung Neoplasms / secondary. Vulvar Neoplasms / genetics. Vulvar Neoplasms / pathology

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  • (PMID = 19696623.001).
  • [ISSN] 1538-7151
  • [Journal-full-title] International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
  • [ISO-abbreviation] Int. J. Gynecol. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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19. Wagenaar HC, Colombo N, Vergote I, Hoctin-Boes G, Zanetta G, Pecorelli S, Lacave AJ, van Hoesel Q, Cervantes A, Bolis G, Namer M, Lhommé C, Guastalla JP, Nooij MA, Poveda A, Scotto di Palumbo V, Vermorken JB: Bleomycin, methotrexate, and CCNU in locally advanced or recurrent, inoperable, squamous-cell carcinoma of the vulva: an EORTC Gynaecological Cancer Cooperative Group Study. European Organization for Research and Treatment of Cancer. Gynecol Oncol; 2001 Jun;81(3):348-54
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  • [Title] Bleomycin, methotrexate, and CCNU in locally advanced or recurrent, inoperable, squamous-cell carcinoma of the vulva: an EORTC Gynaecological Cancer Cooperative Group Study. European Organization for Research and Treatment of Cancer.
  • OBJECTIVE: To investigate tumor response rate and treatment toxicity of a modified combination chemotherapy consisting of bleomycin (B), methotrexate (M), and CCNU (C) for patients with locally advanced, squamous-cell carcinoma of the vulva (not amenable to resection by standard radical vulvectomy) or recurrent disease (after incomplete resection).
  • Tumor resectability was reassessed in patients who had responded to chemotherapy.
  • RESULTS: Twenty-five eligible patients with a median age of 66 years (range, 39-82 years) were entered in this phase II trial.
  • CONCLUSION: The present data confirm the therapeutic activity of the BMC regimen in locoregionally advanced or recurrent squamous-cell carcinoma of the vulva.
  • Following neoadjuvant chemotherapy, the overall response rate was 56%.
  • BMC is an outpatient treatment that may play a role in the palliative therapy of advanced or recurrent vulva cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Neoplasm Recurrence, Local / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / adverse effects. Bleomycin / administration & dosage. Bleomycin / adverse effects. Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Lomustine / administration & dosage. Lomustine / adverse effects. Methotrexate / administration & dosage. Methotrexate / adverse effects. Middle Aged. Prospective Studies

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11371121.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 7BRF0Z81KG / Lomustine; YL5FZ2Y5U1 / Methotrexate; BMC protocol
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20. Tamura N, Aoki Y, Fujita K, Tanaka K: Stage IVa squamous cell carcinoma of the vulva managed with primary chemoradiation. Int J Clin Oncol; 2005 Apr;10(2):148-51
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  • [Title] Stage IVa squamous cell carcinoma of the vulva managed with primary chemoradiation.
  • We present the case of a 53-year-old woman with International Federation of Gynecology and Obstetrics stage IVa (T3N2M0) squamous cell carcinoma of the vulva.
  • Because the urethra was surrounded by a vulvar tumor, she was managed with primary chemoradiation in an attempt to spare the morbidity associated with exenterative vulvar surgery.
  • Treatment was given as a planned split course, consisting of two separate courses of 23.8 Gy each.
  • During the 4 days of chemotherapy infusion, the radiation was administered in two daily fractions of 1.7 Gy each, given at least 6 h apart.
  • There was no treatment break due to adverse effect, and a pathological complete response was achieved in the primary tumor and the lymph nodes.
  • Chemoradiation therapy should be considered as an option in patients with locally advanced vulvar cancer to avert the need for exenterative surgery, and to preserve sexual, gastrointestinal, and urinary function.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Fluorouracil / therapeutic use. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Disease-Free Survival. Female. Humans. Infusions, Intravenous. Middle Aged. Treatment Outcome. Urethra / pathology

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  • (PMID = 15864703.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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21. Piura B, Rabinovich A, Huleihel M: [Matrix metalloproteinases and their tissue inhibitors in malignancies of the female genital tract]. Harefuah; 2003 Nov;142(11):786-91, 804

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Matrix metalloproteinases and their tissue inhibitors in malignancies of the female genital tract].
  • Their proteolytic activity depends on their binding to metal Zinc and is controlled by tissue inhibitors of MMP (TIMPs).
  • Since MMPs may serve as markers of tumor behavior and as predictors of survival and since synthetic inhibitors of MMP may have a place in the treatment of cancer, researching MMPs and their tissue inhibitors in malignant diseases has attracted growing attention.
  • Studies on MMPs and their tissue inhibitors in malignancies of the female genital tract have shown the following:.
  • 1) In ovarian carcinoma and cervical carcinoma, over-expression of MMP-2 and MMP-9 is associated with invasiveness, metastatic spread and poor prognosis;.
  • 2) In endometrial carcinoma, MMP-7 (matrilysin) is the main MMP associated with invasiveness, metastatic spread and poor prognosis;.
  • In vulvar squamous cell carcinoma, over-expression of MMP-13 is associated with invasiveness, metastatic spread and poor prognosis.
  • It is speculated that using synthetic drugs that inhibit MMPs in combination with conventional chemotherapy may contribute to the improvement of treatment results in cancer patients.
  • [MeSH-major] Genital Neoplasms, Female / enzymology. Genital Neoplasms, Female / pathology. Matrix Metalloproteinases / metabolism. Tissue Inhibitor of Metalloproteinases / metabolism

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  • (PMID = 14631913.001).
  • [ISSN] 0017-7768
  • [Journal-full-title] Harefuah
  • [ISO-abbreviation] Harefuah
  • [Language] heb
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Israel
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Tissue Inhibitor of Metalloproteinases; EC 3.4.24.- / Matrix Metalloproteinases
  • [Number-of-references] 32
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22. Gadducci A, Cionini L, Romanini A, Fanucchi A, Genazzani AR: Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer. Crit Rev Oncol Hematol; 2006 Dec;60(3):227-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer.
  • During the last decades there has been a continuing evolution in the surgical approach of squamous cell carcinoma of the vulva that has been traditionally treated with radical vulvectomy and bilateral inguinal-femoral lymphadenectomy.
  • Patients with T1 tumour are usually treated with radical local excision, if the lesion is unifocal and the remainder of the vulva is normal.
  • Modifications of the surgical technique of deep femoral lymphadenectomy and the mapping of sentinel node can offer new interesting therapeutic perspectives.
  • Locally advanced squamous cell carcinoma of the vulva has been long surgically treated with en-block radical vulvectomy and bilateral inguinal-femoral lymphadenectomy plus partial resection of urethra, vagina or anum, or by exenteration, with severe postsurgical complications, poor quality of life, and unsatisfactory survival rates.
  • 5-Fluorouracil [5-FU] or 5-FU- and cisplatin-based chemotherapy concurrent with irradiation followed by tailored surgery represents an attractive therapeutic option for advanced disease, planned to avoid such ultra-radical surgical procedures and, hopefully, to improve patient outcome.
  • Chemotherapy has also been used in neoadjuvant setting, with contrasting and generally unsatisfactory results, and in palliative treatment of patients with distant metastases.
  • Surgery is the primary treatment also for vulvar malignancies other than squamous cell carcinoma, whereas the clinical usefulness of adjuvant irradiation or chemotherapy is still to be defined.
  • Primary chemoradiation can be also used for advanced carcinoma of the Bartholin gland or for advanced adenocarcinoma associated with extramammary Paget's disease.
  • The drugs used for chemotherapy of metastatic melanomas or sarcomas of the vulva are the same employed for the melanomas or sarcomas developed in other sites.
  • [MeSH-major] Vulvar Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Neoplasm Metastasis. Recurrence

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  • (PMID = 16945551.001).
  • [ISSN] 1040-8428
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Number-of-references] 167
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23. Oztop I, Demirkan B, Tarhan O, Kayahan H, Yilmaz U, Kargi A, Alakavuklar M: The development of pulmonary adenocarcinoma in a patient with Job's syndrome, a rare immunodeficiency condition. Tumori; 2004 Jan-Feb;90(1):132-5
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  • Lymphoid malignancies have most commonly been associated with this syndrome while the first case in the literature of carcinoma associated with HIE syndrome was a squamous cell carcinoma of the vulva, described by Clark et al. in 1998.
  • Diagnostic procedures aimed at detecting the primary site showed multiple mediastinal lymph nodes with lung and liver metastases on computed tomography scans and an extradural spinal metastasis at the upper thoracic level on magnetic resonance imaging.
  • Although the patient refused a bronchoscopic procedure, a diagnosis of pulmonary adenocarcinoma was established on the basis of sputum cytology and the clinical aspects of tumor extent.
  • Palliative chemotherapy could not be started because of the patient's poor performance status as well as nosocomial fungal pneumonia and pseudomonal urogenital infection with bacteremia.
  • Despite the antifungal and broad-spectrum antimicrobial treatments, the patient died of pseudomonal sepsis.
  • [MeSH-major] Adenocarcinoma / diagnosis. Job Syndrome / complications. Lung Neoplasms / diagnosis. Sepsis / etiology

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  • (PMID = 15143986.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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24. Hoffman KE, Horowitz NS, Russell AH: Healing of vulvo-vaginal radionecrosis following revascularization. Gynecol Oncol; 2007 Jul;106(1):262-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Invasive cancers of the vagina and vulva are treated with radiation-based therapy when proximity of the bladder and/or rectum precludes conservative surgical resection.
  • Patient factors affect non-malignant tissue tolerance to radiation exposure.
  • CASE: A smoker with atherosclerotic disease developed tissue necrosis and the worsening of claudication after chemoradiation treatment of locally advanced squamous cell carcinoma of the vulva and vagina.
  • CONCLUSION: Conditions with impaired microvasculature, such as smoking and atherosclerotic disease, are associated with an increased incidence and severity of complications after radiation treatment.
  • Patients undergoing pelvic radiation treatment should be counseled to modify their vascular risk factors.
  • If this fails and patients develop significant radiation necrosis due to compromised arteriole flow, revascularization or stenting may offer important treatment options.
  • [MeSH-major] Radiation Injuries / surgery. Vagina / blood supply. Vulva / blood supply
  • [MeSH-minor] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Female. Humans. Middle Aged. Necrosis. Radiotherapy / adverse effects. Smoking / adverse effects. Vaginal Neoplasms / drug therapy. Vaginal Neoplasms / radiotherapy. Vascular Surgical Procedures / methods. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy

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  • (PMID = 17507081.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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25. van der Avoort IA, Tiemes DE, van Rossum MM, van der Vleuten CJ, Massuger LF, de Hullu JA: Lichen sclerosus: treatment and follow-up at the departments of gynaecology and dermatology. J Low Genit Tract Dis; 2010 Apr;14(2):118-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Lichen sclerosus: treatment and follow-up at the departments of gynaecology and dermatology.
  • OBJECTIVE: To compare the treatment and follow-up of patients with lichen sclerosus (LS) at the departments of Gynaecology and Dermatology at the Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, to evaluate the need for a multidisciplinary vulvar clinic.
  • MATERIALS AND METHODS: Treatment and follow-up data of all women with histologically proven (between January 1995 and January 2001) anogenital LS visiting the outpatient clinics of the departments of Obstetrics & Gynaecology and Dermatology were collected (last date of follow-up: January 2008).
  • At the Gynaecology department, LS patients more often received surgical treatment, topical estrogens, and lidocaine ointment, whereas at the Dermatology department, local class 2/3 corticosteroids were more often prescribed.
  • One patient developed vulvar squamous cell carcinoma.
  • This patient had withdrawn from follow-up and had her condition diagnosed with carcinoma 74 months after the LS had been diagnosed.
  • CONCLUSIONS: Although no hospital guidelines existed, management of patients with LS agreed with current recommendations in the literature, although differences in secondary and supportive therapy existed owing to differences in expertise.
  • The relatively high percentage of patients treated by both specialties with a high frequency of visits emphasizes the need for a multidisciplinary clinic for vulvar disease.
  • [MeSH-major] Lichen Sclerosus et Atrophicus / drug therapy. Lichen Sclerosus et Atrophicus / surgery
  • [MeSH-minor] Academic Medical Centers. Administration, Topical. Adrenal Cortex Hormones / administration & dosage. Anesthetics, Local / administration & dosage. Anti-Inflammatory Agents / administration & dosage. Estrogens / administration & dosage. Female. Humans. Lidocaine / administration & dosage. Middle Aged. Netherlands. Outpatient Clinics, Hospital. Treatment Outcome

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  • (PMID = 20354420.001).
  • [ISSN] 1526-0976
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Anesthetics, Local; 0 / Anti-Inflammatory Agents; 0 / Estrogens; 98PI200987 / Lidocaine
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26. Smith YR, Haefner HK: Vulvar lichen sclerosus : pathophysiology and treatment. Am J Clin Dermatol; 2004;5(2):105-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Vulvar lichen sclerosus : pathophysiology and treatment.
  • Lichen sclerosus is a chronic disorder of the skin and mucosal surfaces, and is most commonly seen on the female genital skin.
  • Currently, ultra-potent topical corticosteroids are the medical treatment of choice.
  • Other treatments that have been utilized for this condition include testosterone, progesterone, tacrolimus, surgery, and phototherapy.
  • Surgery should be reserved for symptomatic patients who fail to respond to multiple medical treatments, as there is a high recurrence rate following surgery.
  • The risk of developing squamous cell carcinoma of the vulva approaches 5% in women with vulvar lichen sclerosus, and therefore close surveillance by the healthcare provider and patient is needed.
  • This review discusses the history, clinical features, pathophysiology, and treatment of lichen sclerosus of the vulva, as well as pregnancy issues and sexual function in patients with this condition.
  • [MeSH-major] Lichen Sclerosus et Atrophicus / drug therapy. Lichen Sclerosus et Atrophicus / physiopathology. Vulvar Diseases / drug therapy. Vulvar Diseases / physiopathology

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  • (PMID = 15109275.001).
  • [ISSN] 1175-0561
  • [Journal-full-title] American journal of clinical dermatology
  • [ISO-abbreviation] Am J Clin Dermatol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 3XMK78S47O / Testosterone
  • [Number-of-references] 220
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27. Guirguis A, Kanbour-Shakir A, Kelley J: Epithelioid angiosarcoma of the mons after chemoradiation for vulvar cancer. Int J Gynecol Pathol; 2007 Jul;26(3):265-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Epithelioid angiosarcoma of the mons after chemoradiation for vulvar cancer.
  • She was a 74-year-old woman who initially presented with stage II keratinizing squamous cell carcinoma of the vulva that underwent neoadjuvant chemoradiation followed by a radical vulvectomy with bilateral inguinal-femoral lymphadenectomy.
  • She presented 4 years later with a lesion on her mons, consistent with an angiosarcoma.
  • Our patient is the first case report of an angiosarcoma of the mons pubis after chemoradiation for vulvar cancer and the second reported angiosarcoma of the mons.
  • Time to presentation was approximately 4 years from the time of completion of chemoradiation.
  • She currently is undergoing systemic chemotherapy after being diagnosed with a metastatic pelvic lymph node.
  • As the treatment of vulvar cancer evolves, and more radiation therapy is given, the incidence of angiosarcomas will rise, requiring better diagnostic and treatment protocols.
  • [MeSH-major] Hemangiosarcoma / pathology. Vulvar Neoplasms / pathology
  • [MeSH-minor] Aged. Female. Humans. Immunohistochemistry. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / therapy

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  • (PMID = 17581409.001).
  • [ISSN] 0277-1691
  • [Journal-full-title] International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
  • [ISO-abbreviation] Int. J. Gynecol. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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28. Cormio G, Loizzi V, Carriero C, Cazzolla A, Putignano G, Selvaggi L: Groin recurrence in carcinoma of the vulva: management and outcome. Eur J Cancer Care (Engl); 2010 May;19(3):302-7
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  • [Title] Groin recurrence in carcinoma of the vulva: management and outcome.
  • The aim of the study was to investigate the management and outcome of inguinal recurrence in vulvar carcinoma patients.
  • A retrospective chart review was conducted on 140 patients with squamous cell carcinoma of the vulva treated between 1994 and 2006.
  • Median interval between primary treatment of vulvar cancer and groin recurrence was 7 months.
  • Three patients refused any treatment, 3 received chemotherapy, 2 inguino-pelvic radiotherapy and 13 had resection of the groin recurrence.
  • After surgery seven patients received irradiation of the groin and pelvis, and three patients received chemotherapy.
  • One patient died following surgery; 19 patients died of disease with the median survival after diagnosis of inguinal recurrence of 9 months.
  • In univariate analysis, stage and grade at diagnosis, age and performance status at the recurrent disease, and the extent of residual tumour after resection of groin recurrence were predictors for survival.
  • Groin recurrences from vulvar carcinoma carry a poor prognosis.
  • Multi-modal treatment may result in a palliation of the disease, and a very limited number of patients have long-term survival.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / therapy. Vulvar Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy / methods. Female. Groin. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Analysis

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  • (PMID = 19832900.001).
  • [ISSN] 1365-2354
  • [Journal-full-title] European journal of cancer care
  • [ISO-abbreviation] Eur J Cancer Care (Engl)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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29. Diaz A, Batista AE, Montero E: Interferon-alpha conditioned sensitivity to an anti-epidermal growth factor receptor monoclonal antibody in a human lung cancer cell line with intermediate expression of the receptor. J Interferon Cytokine Res; 2009 Aug;29(8):433-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Interferon-alpha conditioned sensitivity to an anti-epidermal growth factor receptor monoclonal antibody in a human lung cancer cell line with intermediate expression of the receptor.
  • Targeted therapy to the epidermal growth factor receptor (EGFR) seems to be related to its expression level on tumor cells.
  • Interferon-alpha (IFN-alpha) induces growth inhibition but also may up-regulate the EGFR expression in some cancer cell lines.
  • We aimed to determine whether the IFN-alpha combined with an EGFR-specific monoclonal antibody (nimotuzumab) may affect the growth of human tumor epithelial cell lines with different EGFR expression levels.
  • H125, a lung adenosquamous carcinoma, and A431, a vulvar epidermoid carcinoma, cell lines express intermediate and high levels of EGFR, respectively, whereas MDA MB231, a breast adenocarcinoma cell line expresses undetectable levels of EGFR measured by flow cytometry/FACS.
  • We found that IFN-alpha alone inhibited in a dose-dependent fashion the growth of all cell lines, but only up-regulated the EGFR expression in the lung carcinoma-derived cell line.
  • Noteworthy, the combined treatment did not modify the complement-mediated cytotoxicity of the antibody although the antiproliferative activity of nimotuzumab in H125 cells in vitro increased when an IFN-alpha-conditioning treatment was used.
  • In conclusion, this study may provide insights about the rational use of EGFR inhibitors into the immunopharmacological management of targeted therapies including the IFN-alpha for lung cancer.
  • [MeSH-major] Antibodies, Monoclonal / pharmacology. Epithelial Cells / immunology. Growth Inhibitors / metabolism. Immunologic Factors / pharmacology. Immunotherapy. Interferon-alpha / metabolism. Lung Neoplasms / immunology. Lung Neoplasms / therapy. Receptor, Epidermal Growth Factor / immunology
  • [MeSH-minor] Antibodies, Monoclonal, Humanized. Breast Neoplasms / immunology. Breast Neoplasms / metabolism. Breast Neoplasms / pathology. Breast Neoplasms / therapy. Cell Growth Processes / drug effects. Cell Line, Tumor. Cell Separation. Complement System Proteins / metabolism. Cytotoxicity, Immunologic / drug effects. Dose-Response Relationship, Immunologic. Drug Synergism. Female. Flow Cytometry. Gene Expression Regulation, Neoplastic. Humans. Vulvar Neoplasms / immunology. Vulvar Neoplasms / metabolism. Vulvar Neoplasms / pathology. Vulvar Neoplasms / therapy

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  • (PMID = 19514842.001).
  • [ISSN] 1557-7465
  • [Journal-full-title] Journal of interferon & cytokine research : the official journal of the International Society for Interferon and Cytokine Research
  • [ISO-abbreviation] J. Interferon Cytokine Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Growth Inhibitors; 0 / Immunologic Factors; 0 / Interferon-alpha; 0 / nimotuzumab; 9007-36-7 / Complement System Proteins; EC 2.7.10.1 / Receptor, Epidermal Growth Factor
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30. Renaud-Vilmer C, Cavelier-Balloy B, Porcher R, Dubertret L: Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol; 2004 Jun;140(6):709-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease.
  • BACKGROUND: Lichen sclerosus is an inflammatory disease of unknown etiology affecting the anogenital skin and associated with the development of squamous cell carcinoma.
  • It is not known whether long-term topical treatment with a potent steroid can cure this disease and thus prevent malignant evolution.
  • OBJECTIVES: To analyze the rates of remission, recurrence, and chronic evolution of vulvar lichen sclerosus (VLS) treated with 0.05% clobetasol propionate ointment and determine whether this treatment can decrease the risk of malignant evolution.
  • The 8 observed vulvar squamous cell carcinomas (9.6%) occurred in previously untreated or irregularly treated VLS lesions.
  • CONCLUSIONS: Treatment with a potent steroid cream can improve but does not cure VLS in women older than 70 years, probably because of a long disease evolution.
  • Although a protective effect from malignant evolution is suggested (carcinoma developed only in nontreated or irregularly treated VLS lesions), the number of seemingly protected patients was too small to be statistically significant.
  • [MeSH-major] Glucocorticoids / administration & dosage. Lichen Sclerosus et Atrophicus / drug therapy. Neoplasm Recurrence, Local / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Cutaneous. Adult. Aged. Aged, 80 and over. Drug Administration Schedule. Female. Humans. Longitudinal Studies. Middle Aged. Prospective Studies. Treatment Outcome

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  • (PMID = 15210462.001).
  • [ISSN] 0003-987X
  • [Journal-full-title] Archives of dermatology
  • [ISO-abbreviation] Arch Dermatol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Glucocorticoids
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