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1. Witteveen PO, van der Velden J, Vergote I, Guerra C, Scarabeli C, Coens C, Demonty G, Reed N: Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group). Ann Oncol; 2009 Sep;20(9):1511-6
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  • [Title] Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group).
  • BACKGROUND: No standard treatment options are available for patients with advanced, recurrent or metastatic vulvar carcinoma not amenable for locoregional treatment.
  • PATIENTS AND METHODS: In this phase II study, patients with advanced vulvar cancer received paclitaxel (Taxol) every 3 weeks for up to 10 cycles.
  • SAFETY: Grade 3 and 4 neutropenia was seen in eight patients (8/29 = 27.6%), which in one patient resulted in neutropenic fever and treatment-related death.
  • Further treatment-related grade 3/4 toxicity includes fatigue in three patients (10.3%) and neuropathy in one patient (3.4%).
  • CONCLUSION: Paclitaxel shows moderate activity for local control in advanced vulvar cancer.

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  • (PMID = 19487487.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / 3U10 CA11488-31; United States / NCI NIH HHS / CA / 5U10 CA011488-38
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2731017
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2. Diaz-Arrastia C, Arany I, Robazetti SC, Dinh TV, Gatalica Z, Tyring SK, Hannigan E: Clinical and molecular responses in high-grade intraepithelial neoplasia treated with topical imiquimod 5%. Clin Cancer Res; 2001 Oct;7(10):3031-3
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  • OBJECTIVE: To assess the clinical and molecular response of patients with recurrent high-grade vulvar, vaginal, or cervical intraepithelial neoplasia treated with topical 1-2(2-methylpropyl)-1H-imidazo [4,5-c] quinolin-4-amine (imiquimod) cream 5%, an immune response modifier with known efficacy in the treatment of external genital warts.
  • Frozen biopsies were available for RNA extraction on four patients before and after therapy.
  • RESULTS: Of the patients treated, four had complete responses, two had partial responses, one progressed, and one did not tolerate the therapy.
  • 2',5'-Oligoadenylate synthetase RNA expression showed an increased trend after therapy.
  • CONCLUSIONS: These results obtained in this small and heterogeneous group merit further study in the use of topical 5% imiquimod use in the treatment of intraepithelial neoplasia.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Cervical Intraepithelial Neoplasia / drug therapy. Genital Neoplasms, Female / drug therapy
  • [MeSH-minor] 2',5'-Oligoadenylate Synthetase / genetics. Administration, Topical. Adult. Female. Follow-Up Studies. Gene Expression Regulation, Enzymologic / drug effects. Gene Expression Regulation, Neoplastic / drug effects. Humans. Middle Aged. Ointments. RNA, Neoplasm / genetics. RNA, Neoplasm / metabolism. Time Factors. Treatment Outcome. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / genetics. Vaginal Neoplasms / drug therapy. Vaginal Neoplasms / genetics. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / genetics

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  • (PMID = 11595691.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / Ointments; 0 / RNA, Neoplasm; 99011-02-6 / imiquimod; EC 2.7.7.- / 2',5'-Oligoadenylate Synthetase
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3. Salom EM, Penalver M: Recurrent vulvar cancer. Curr Treat Options Oncol; 2002 Apr;3(2):143-53
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  • [Title] Recurrent vulvar cancer.
  • Recurrent vulvar cancer occurs in an average of 24% of cases after primary treatment after surgery with or without radiation.
  • The relatively few primary vulvar cancers, combined with the low proportion of recurrences, has made it difficult to perform randomized studies to document the most appropriate therapeutic modalities.
  • Traditionally, the most accepted treatment of vulvar cancer has been and continues to be surgery.
  • Recently, radiation and chemotherapy have been combined with very encouraging results.
  • The therapeutic modality used depends on the location and extent of the recurrence.
  • Lateralized local vulvar recurrences treated with a wide radical local excision with inguinal lymphadectomy results in an excellent cure rate of 70%.
  • Radiotherapy or chemoradiation concomitantly with wide radical local excision of an advanced vulvar has proven successful in avoiding an exenteration, with improved survival and less morbidity.
  • We recommend that inguinal recurrences without prior radiation therapy undergo excision followed by radiotherapy with chemosensitization.
  • With pelvic recurrences, we recommended chemoradiation as the treatment modality.
  • In the subset of patients with distant metastasis, chemotherapy may be offered; however, few studies have been performed to advocate any single combination.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / therapy. Vulvar Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Practice Guidelines as Topic

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  • (PMID = 12057077.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 27
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4. van Rijswijk RE, Vermorken JB: Drug therapy for gynaecological cancer in older women. Drugs Aging; 2000 Jul;17(1):13-32
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  • [Title] Drug therapy for gynaecological cancer in older women.
  • Differences in biological behaviour, stage of the disease at presentation, and reluctance to undergo aggressive treatment with its associated morbidity are among the factors thought to be responsible for this difference in outcomes.
  • However, investigations also indicate that elderly patients may receive less surgical and chemotherapeutic treatment without obvious clinical rationale.
  • This overview is aimed at providing a guideline of chemotherapy appropriate for patients with epithelial ovarian, uterine (corpus and cervix), and vulvar cancer, aged 70 to 75 years and over.
  • Platinum-based chemotherapy is the cornerstone of drug treatment in patients with ovarian cancer.
  • Patients aged between 70 and 75 years with a good performance status can be treated with cisplatin- or carboplatin-based chemotherapy.
  • For patients with early recurrence there is no standard treatment, but several cytostatic and hormonal agents can be used with palliative intent.
  • In metastatic endometrial cancer, hormonal therapy is the first choice in tumours expressing a progesterone receptor.
  • Poorly differentiated tumours infrequently respond to endocrine therapy.
  • In this situation, and for patients with tumours that have become resistant to hormonal manipulation, platinum-based chemotherapy may be used.
  • The usefulness of chemotherapy in elderly patients with cervical cancer is limited.
  • In case of recurrent or metastatic disease, the use of single agent (low-dose) cisplatin should be balanced against best supportive care.
  • Although overall chemoradiation seems superior than radiotherapy alone in patients with locally advanced cervical cancer, the feasibility of this approach in elderly patients needs further investigation.
  • Chemoradiation might also be considered in patients with locally advanced vulvar cancer.
  • However, treatment-related morbidity can be considerable and randomised studies are lacking to prove a survival benefit.
  • Our understanding of the tolerance and effectiveness of chemotherapy in elderly patients is still incomplete due to a paucity of trials that specifically focus on this subset of patients.
  • However, there appears no argument to withhold chemotherapy based purely on age.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Genital Neoplasms, Female / drug therapy
  • [MeSH-minor] Age Factors. Aged. Aged, 80 and over. Endometrial Neoplasms / drug therapy. Female. Humans. Neoplasm Recurrence, Local / drug therapy. Neoplasms, Glandular and Epithelial / drug therapy. Ovarian Neoplasms / drug therapy. Uterine Cervical Neoplasms / drug therapy. Vulvar Neoplasms / drug therapy

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  • (PMID = 10933513.001).
  • [ISSN] 1170-229X
  • [Journal-full-title] Drugs & aging
  • [ISO-abbreviation] Drugs Aging
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 203
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5. 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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6. Hruby G, MacLeod C, Firth I: Radiation treatment in recurrent squamous cell cancer of the vulva. Int J Radiat Oncol Biol Phys; 2000 Mar 15;46(5):1193-7
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  • [Title] Radiation treatment in recurrent squamous cell cancer of the vulva.
  • PURPOSE: To evaluate the treatment and outcome of recurrent vulvar cancer.
  • METHODS AND MATERIALS: In a retrospective review of 26 women referred to the department of radiation oncology between 1982 and 1995, patient records were analyzed with respect to the findings at original surgery, the time to locoregional recurrence, the location of the recurrence, and the subsequent management and outcome.
  • RESULTS: Sixteen recurrences were managed with a combination of surgery and radiotherapy, and the remainder with radiation treatment, combined with chemotherapy in some cases.
  • The 5-year survival for those with recurrence confined to the vulva (n = 13) was 46%, compared with 0% for those women with a recurrence located or extending beyond the vulva (p = 0.002).
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Neoplasm Recurrence, Local / radiotherapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cause of Death. Cohort Studies. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Middle Aged. Radiotherapy Dosage. Retrospective Studies

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  • (PMID = 10725631.001).
  • [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
  • [Publication-country] UNITED STATES
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7. Cormio G, Loizzi V, Gissi F, Serrati G, Panzarino M, Carriero C, Selvaggi L: Cisplatin and vinorelbine chemotherapy in recurrent vulvar carcinoma. Oncology; 2009;77(5):281-4
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  • [Title] Cisplatin and vinorelbine chemotherapy in recurrent vulvar carcinoma.
  • PURPOSE: To evaluate the activity and toxicity of the combination of cisplatin and vinorelbine in patients with recurrent carcinoma of the vulva that has not been previously treated with chemotherapy.
  • PATIENTS AND METHODS: Sixteen women with a median age of 65 years (range 43-79) with recurrent vulvar carcinoma were enrolled in the study.
  • Nine patients had local recurrent disease (perineum, vagina and/or vulva), whereas 7 had disease in the groin; 9 patients had received prior radiotherapy.
  • RESULTS: A total of 68 cycles of chemotherapy were administered.
  • The median progression-free survival was 10 months (range 3-17), whereas the overall survival from the beginning of the chemotherapy was 19 months (range 1-30).
  • CONCLUSION: The combination of cisplatin and vinorelbine is a well-tolerated and active regimen in the treatment of patients with recurrent vulvar carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasm Recurrence, Local / drug therapy. Vulvar Neoplasms / drug therapy

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19923866.001).
  • [ISSN] 1423-0232
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; Q6C979R91Y / vinorelbine
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8. Basile S, Angioli R, Manci N, Palaia I, Plotti F, Benedetti Panici P: Gynecological cancers in developing countries: the challenge of chemotherapy in low-resources setting. Int J Gynecol Cancer; 2006 Jul-Aug;16(4):1491-7
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  • [Title] Gynecological cancers in developing countries: the challenge of chemotherapy in low-resources setting.
  • Cancer natural history, microbiologic environment, patient's immune system, and drug availability may differ as well.
  • Four of five new cases of cervical cancer and most of cervical cancer deaths occur in developing countries.
  • Where chemoradiation and supportive care facilities are unavailable, it would be logical to consider an inexpensive effective drug.
  • In locally advanced cases, neoadjuvant chemotherapy followed by surgery should be considered the treatment of choice.
  • For ovarian cancer, it may be reasonable to maintain a secure supply of platinum and/or taxanes.
  • For endometrial cancer, platinum compounds are proved active chemotherapic single agents.
  • Oral medroxyprogesterone acetate (MPA) may represent a good chance for treating an advanced or recurrent disease.
  • For vulvar/vaginal cancer, the role of chemotherapy alone is currently considered limited, and it is mostly used as palliative treatment in advanced or recurrent cases.
  • When standard therapies are unavailable, drugs of choice should be easily accessible, inexpensive, and effective.
  • The most commonly used drugs are cisplatin, cyclophosphamide, and MPA.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Developing Countries. Genital Neoplasms, Female / drug therapy. Genital Neoplasms, Female / epidemiology. Health Resources / supply & distribution

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  • (PMID = 16884356.001).
  • [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] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 66
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9. 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.
  • 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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10. 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.
  • 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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11. 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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  • [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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12. Temkin SM, Hellman M, Lee YC, Abulafia O: Surgical resection of vulvar metastases of endometrial cancer: a presentation of two cases. J Low Genit Tract Dis; 2007 Apr;11(2):118-21
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  • [Title] Surgical resection of vulvar metastases of endometrial cancer: a presentation of two cases.
  • OBJECTIVE: Endometrial cancer generally carries a good prognosis.
  • However, 10% to 15% of patients will manifest recurrent disease.
  • Whereas pelvic recurrence is most common in patients who do not receive postoperative adjuvant radiation therapy, distant metastases predominate among patients who received postoperative radiation therapy.
  • Surgical resection of disease may be possible, therapeutic and even curative, in select patients with isolated cancer recurrence.
  • CASE 1: A 63-year-old patient presented 7 years after treatment of endometrial cancer with a vulvar lesion and groin mass.
  • The lesions were successfully resected and confirmed to be recurrent endometrial cancer.
  • Adjuvant radiation and chemotherapy were prescribed leading to a complete clinical response.
  • CASE 2: An 83-year-old patient with a history of a hysterectomy for endometrial cancer and radiation therapy for a vaginal vault recurrence presented with an exophytic labial mass.
  • After radical wide excision of her vulvar mass and bilateral groin dissection, final pathology revealed that the mass was consistent with recurrent endometrial cancer.
  • This patient remains without evidence of disease 18 months after treatment of disease recurrence.
  • CONCLUSIONS: Uncommon sites of recurrence of endometrial cancer may include the vulva.
  • These rare metastases may be amenable to surgical resection with adjuvant therapy as indicated.
  • [MeSH-major] Adenocarcinoma / surgery. Endometrial Neoplasms / pathology. Gynecologic Surgical Procedures. Vulvar Neoplasms / surgery
  • [MeSH-minor] Aged, 80 and over. Chemotherapy, Adjuvant. Female. Humans. Middle Aged. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 17415118.001).
  • [ISSN] 1089-2591
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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13. Sharma S, Odunsi K, Lele S: Pelvic exenterations for gynecologic malignancies: 20-year experience at a cancer institute. J Clin Oncol; 2004 Jul 15;22(14_suppl):5138

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pelvic exenterations for gynecologic malignancies: 20-year experience at a cancer institute.
  • Most common indication is centrally recurrent or persistent cancer of the cervix after radiation therapy.
  • The goal of this study is to retrospectively review gynecologic patients that have undergone pelvic exenterations at a single cancer institution.
  • 48 patients were reviewed by organ, histology, stage and type of exenteration.
  • RESULTS: 48 patients (ages 21-78) underwent pelvic exenterations for cervical (39), vulvar (3), endometrial (2), ovarian (2), and vaginal (2) cancers.
  • Majority of patients (45) had received prior radiation therapy.
  • Mortality from the procedure was 4.2%.
  • Univariate analysis failed to show an association between type of pelvic exenteration, type of fecal and urinary diversion, outcome, need for reoperation, and recurrence.
  • In patients with recurrent gynecological cancer confined centrally to the pelvis, pelvic exenteration still remains the choice of therapy as response to chemotherapy to a centrally recurrent tumor in radiated area continues to be poor.

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  • (PMID = 28016752.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Mourton SM, Sonoda Y, Abu-Rustum NR, Bochner BH, Barakat RR, Chi DS: Resection of recurrent cervical cancer after total pelvic exenteration. Int J Gynecol Cancer; 2007 Jan-Feb;17(1):137-40
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  • [Title] Resection of recurrent cervical cancer after total pelvic exenteration.
  • The objective of this study was to describe the management of patients with recurrent cervical cancer after total pelvic exenteration (TPE).
  • We reviewed the records of patients who underwent TPE for recurrent cervical cancer between June 1992 and December 2003 and subsequently developed recurrent disease.
  • Thirty-seven patients underwent TPE during the study period, and 25 (68%) subsequently developed recurrence proven by radiographic and/or biopsy studies.
  • Recurrence sites included pelvic (12), inguinal (5), retroperitoneal (5), hepatic (4), vulva (2), perineum (1), transposed ovary (1), and lung (1).
  • The median time to recurrence was 7 months (range 2-73 months), with 92% (23/25) occurring within 2 years of TPE.
  • Management of recurrence was known in 21 of 25 patients, which included chemotherapy (10), surgical resection (7), and no further treatment (4).
  • Surgically resected recurrences were isolated to the groin (2), vulva (2), perineum (1), transposed ovary (1), and psoas muscle (1).
  • The four patients who underwent ovarian, perineal, and vulvar resections succumbed to their disease in a median time of 13 months (range 2-21 months).

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  • (PMID = 17291244.001).
  • [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] Journal Article
  • [Publication-country] United States
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15. Kyriazi MA, Stafyla VK, Kondi-Pafiti A, Arkadopoulos N, Dafnios N, Hasiakos D, Fotiou S, Mastorakos D, Smyrniotis V: A novel technique for surgical reconstruction of the perineal floor following anteroposterior exenteration of the pelvis--case report and review of the literature. Eur J Gynaecol Oncol; 2010;31(2):201-5
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  • Pelvic exenteration is the only potentially curative surgical procedure for patients with recurrent cervical, vaginal, vulvar or rectal cancers, especially following adjuvant chemotherapy or radiotherapy.
  • We describe a novel reconstruction technique of the pelvic floor, involving a combination of an oblique rectus abdominis myocutaneous flap and a synthetic absorbable mesh as a pelvic sling for additional support, in a 63-year-old female patient with recurrent vulvar carcinoma.
  • [MeSH-major] Carcinoma / surgery. Pelvic Exenteration / methods. Reconstructive Surgical Procedures / methods. Vulvar Neoplasms / surgery

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  • (PMID = 20527241.001).
  • [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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16. Rinaldi M, Cormio G, Bucaria V, Di Tonno P, Marino F, Altomare DF: [Reconstruction with skin flaps of the posterior aspect of the thighs after total pelvic evisceration with removal of vulvo-perineal soft tissues in recurrent vulvar squamous carcinoma]. Suppl Tumori; 2005 May-Jun;4(3):S208
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  • [Title] [Reconstruction with skin flaps of the posterior aspect of the thighs after total pelvic evisceration with removal of vulvo-perineal soft tissues in recurrent vulvar squamous carcinoma].
  • [Transliterated title] Ricostruzione con lembi cutanei della faccia posteriore delle cosce dopo evisceratio pelvica totale con asportazione dei tessuti molli vulvo-perineali per carcinoma squamoso vulvare recidivo.
  • We report of a case of a fortythree years old women affected by squamous cell cancer of the vulva (T3N0M0).
  • Despite curative treatment (radical vulvectomy with bilateral inguinal and femoral lymphadenectomy), after 41 months she had a local recurrence, retreated with surgery and radiotherapy; another recurrence, after 29 months was treated with chemotherapy, without results.
  • Because of local diffusion with infiltration of the urethra and anus, the patient was submitted to demolitive operation (total pelvic evisceratio, excision of pelvic and perineal soft tissues and reconstruction with rotating skin flaps of the posterior face of the thighs).
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Neoplasm Recurrence, Local / surgery. Pelvic Exenteration. Perineum. Reconstructive Surgical Procedures / methods. Soft Tissue Neoplasms / surgery. Surgical Flaps. Thigh / surgery. Vulvar Neoplasms / surgery

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  • (PMID = 16437992.001).
  • [ISSN] 2283-5423
  • [Journal-full-title] I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
  • [ISO-abbreviation] Suppl Tumori
  • [Language] ita
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Italy
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17. Frumovitz M, Ramirez PT, Tortolero-Luna G, Malpica A, Eifel P, Burke TW, Levenback C: Characteristics of recurrence in patients who underwent lymphatic mapping for vulvar cancer. Gynecol Oncol; 2004 Jan;92(1):205-10
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  • [Title] Characteristics of recurrence in patients who underwent lymphatic mapping for vulvar cancer.
  • OBJECTIVE: To evaluate patients with vulvar cancer who experienced a recurrence after undergoing lymphatic mapping and sentinel lymph node (SLN) biopsy.
  • METHODS: We reviewed the records of 52 patients who underwent vulvectomy and lymphatic mapping with blue dye for treatment of vulvar cancer at our institution from 1993 to 1999 and identified patients who experienced recurrent disease.
  • Postoperatively, seven patients underwent no further treatment, six underwent radiation therapy, and one patient underwent chemotherapy.
  • Primary recurrence was in the vulva in eight patients (57%), in the groin in three patients (21%), and distant in three patients (21%).
  • Groin relapse following a negative SLN biopsy is of concern and suggests that long-term follow-up data are required before lymphatic mapping and SLN biopsy alone can be considered standard treatment for patients with vulvar cancer.
  • [MeSH-major] Lymph Nodes / pathology. Neoplasm Recurrence, Local / pathology. Sentinel Lymph Node Biopsy / methods. Vulvar Neoplasms / pathology

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  • (PMID = 14751159.001).
  • [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] 0 / Rosaniline Dyes; 39N9K8S2A4 / iso-sulfan blue
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18. Koonsaeng S, Verschraegen C, Freedman R, Bossens M, Kudelka A, Kavanagh J, Sittisomwong T, DeClercq E, Snoeck R: Successful treatment of recurrent vulvar intraepithelial neoplasia resistant to interferon and isotretinoin with cidofovir. J Med Virol; 2001 Jun;64(2):195-8
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  • [Title] Successful treatment of recurrent vulvar intraepithelial neoplasia resistant to interferon and isotretinoin with cidofovir.
  • Vulvar intraepithelial neoplasias are difficult to eradicate completely without extensive surgical intervention.
  • Cidofovir, a deoxycytidine monophosphate analog, may have a therapeutic role in this disease.
  • A 43-year-old woman with a 20-year history of genital warts presented with extensive vulvar intraepithelial neoplasia III, and refused surgical resection.
  • Successive treatment applications, however, were necessary.
  • Cidofovir is a promising topical antiviral compound for HPV induced vulvar intraepithelial neoplasia.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma in Situ / drug therapy. Cytosine / therapeutic use. Neoplasm Recurrence, Local / prevention & control. Organophosphonates. Organophosphorus Compounds / therapeutic use. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Oral. Administration, Topical. Adult. Cervical Intraepithelial Neoplasia / drug therapy. Drug Resistance, Multiple. Female. Humans. Injections, Subcutaneous. Interferons / therapeutic use. Isotretinoin / therapeutic use

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  • [Copyright] Copyright 2001 Wiley-Liss, Inc.
  • (PMID = 11360253.001).
  • [ISSN] 0146-6615
  • [Journal-full-title] Journal of medical virology
  • [ISO-abbreviation] J. Med. Virol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Organophosphonates; 0 / Organophosphorus Compounds; 8J337D1HZY / Cytosine; 9008-11-1 / Interferons; EH28UP18IF / Isotretinoin; JIL713Q00N / cidofovir
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19. Yen TC, Lai CH: Positron emission tomography in gynecologic cancer. Semin Nucl Med; 2006 Jan;36(1):93-104
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  • [Title] Positron emission tomography in gynecologic cancer.
  • Most positron emission tomography (PET) imaging studies in gynecologic cancer are performed using (18)F-fluorodeoxyglucose (FDG).
  • It contributes valuable information in primary staging of untreated advanced cervical cancer, in the post-treatment surveillance with unexplained tumor marker (such as squamous cell carcinoma antigen [SCC-Ag]) elevation or suspicious of recurrence, and restaging of potentially curable recurrent cervical cancer.
  • Its value in early-stage resectable cervical cancer is questionable.
  • In ovarian cancer, FDG-PET provides benefits for those with plateaued or increasing abnormal serum CA 125 (>35 U/mL), computed tomography and/or magnetic resonance imaging (CT-MRI) defined localized recurrence feasible for local destructive procedures (such as surgery, radiotherapy, or radiofrequency ablation), and clinically suspected recurrent or persistent cancer for which CT-guide biopsy cannot be performed.
  • The role of FDG-PET in endometrial cancer is relatively less defined because of the lack of data in the literature.
  • In our prospective study, FDG-PET coupled with MRI-CT may facilitate optimal management of endometrial cancer in well-selected cases.
  • The clinical impact was positive in 29 (48.3%) of the 60 scans, 22.2% for primary staging, 73.1% for post-therapy surveillance, and 57.1% after salvage therapy, respectively.
  • Scant studies have been reported in the management of vulvar cancer using FDG-PET.
  • Our preliminary results suggest that FDG-PET is potentially useful in selected gestational trophoblastic neoplasia by providing a precise metastatic mapping of tumor extent up front, monitoring response, and localizing viable tumors after chemotherapy.
  • The evaluation of a diagnostic tool, such as PET, is usually via comparing the diagnostic efficacy (sensitivity, specificity, etc), by using a more sophisticated receiver operating curve method, or the proportion of treatment been modified.
  • [MeSH-major] Fluorodeoxyglucose F18. Genital Neoplasms, Female / radionuclide imaging. Positron-Emission Tomography / methods

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  • (PMID = 16356798.001).
  • [ISSN] 0001-2998
  • [Journal-full-title] Seminars in nuclear medicine
  • [ISO-abbreviation] Semin Nucl Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 136
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20. Coulter J, Gleeson N: Local and regional recurrence of vulval cancer: management dilemmas. Best Pract Res Clin Obstet Gynaecol; 2003 Aug;17(4):663-81
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  • [Title] Local and regional recurrence of vulval cancer: management dilemmas.
  • Vulval cancer has an incidence of 1-2/100000.
  • Approximately one-third of patients develop recurrent disease usually within the first 2 years following primary treatment.
  • Chemoradiation therapy may be used pre-operatively or to palliate the disease.
  • Surgical effort to debulk large-volume groin disease is often unsuccessful and chemoradiation therapy is the cornerstone of treatment.
  • The management of retroperitoneal and distant disease recurrence is generally based on symptom control as radiation therapy and chemotherapy have limited success.
  • Palliative medicine should be integrated early in the management plan both in patients with incurable recurrent disease and in those undergoing potentially curative treatments.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / therapy. Palliative Care / methods. Vulvar Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Hemorrhage / therapy. Humans. Inguinal Canal. Neoadjuvant Therapy. Pelvis. Radiotherapy, Adjuvant. Terminal Care / methods

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  • (PMID = 12965138.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 55
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21. Barton DP: The prevention and management of treatment related morbidity in vulval cancer. Best Pract Res Clin Obstet Gynaecol; 2003 Aug;17(4):683-701
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The prevention and management of treatment related morbidity in vulval cancer.
  • The traditional and the most common management of primary vulval cancer is radical surgery of the vulva and radical groin lymphadenectomy (unilateral or bilateral).
  • Rare vulval cancers, locally advanced cancers and recurrent vulval cancers often are treated with a combination of surgery, radiation therapy and chemotherapy.
  • The treatments, while often curative, are associated with considerable morbidity, which, until recently, has not been well publicized or quantified.
  • Increasingly, younger patients are presenting with extensive and often multi-focal pre-invasive disease and with vulval cancer.
  • Long-term post-treatment physical, sexual and psychological morbidity is of major concern.
  • There is more onus on clinicians to provide less radical but equally curative treatment, while also reducing morbidity.
  • There is also the need to provide treatment and treatment modification based on supporting evidence.
  • For a rare disease such as vulval cancer it is more difficult to generate data and to conduct trials on treatment modifications.
  • Although surgical modifications have been made, the morbidity of radical surgery for vulval cancer is considerable.
  • The prevention and management of treatment-related morbidity will continue to challenge the gynaecological oncology team.
  • [MeSH-major] Neoplasm Recurrence, Local / therapy. Vulvar Neoplasms / surgery
  • [MeSH-minor] Aged. Female. Humans. Inguinal Canal. Lymph Node Excision. Lymphedema / therapy. Middle Aged. Morbidity. Patient Education as Topic. Quality of Life. Sexual Dysfunctions, Psychological / therapy. Treatment Outcome

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  • (PMID = 12965139.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 71
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22. Mottl H, Rob L, Stary J, Kodet R, Drahokoupilova E: Langerhans cell histiocytosis of vulva in adolescent. Int J Gynecol Cancer; 2007 Mar-Apr;17(2):520-4
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  • [Title] Langerhans cell histiocytosis of vulva in adolescent.
  • Langerhans cell histiocytosis (LCH) affecting child vulva alone is a very rare disease.
  • Only 13 cases of primary vulvar LCH have been previously reported in the medical literature.
  • We describe an additional case in which the LCH was confined to the vulva, with review of the literature.
  • A metastatic work-up did not reveal any evidence of the disease except on the vulva.
  • Treatment was carried out according to LCH II protocol.
  • The patient was diagnosed with a recurrent disorder in the vulva 8 months after the completion of primary chemotherapy.
  • For this reason, she underwent second line treatment with 2-chlorodeoxyadenosine.
  • Eighteen months after the second line chemotherapy, the patient has no signs of a local or systemic recurrence.
  • Primary LCH of vulva is very unusual, but we have to keep in mind this possibility when an adolescent girl presents with an atypical chronic lesion on the vulva.
  • This patient appears to be the first case of adolescent 16.5 year old having a solely cutaneous lesion of the vulva.
  • [MeSH-major] Histiocytosis, Langerhans-Cell / diagnosis. Vulvar Diseases / diagnosis

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  • (PMID = 17362323.001).
  • [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
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23. Lai CH, Yen TC, Chang TC: Positron emission tomography imaging for gynecologic malignancy. Curr Opin Obstet Gynecol; 2007 Feb;19(1):37-41
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  • [Title] Positron emission tomography imaging for gynecologic malignancy.
  • PURPOSE OF REVIEW: The utility of positron emission tomography (PET) in gynecologic malignancy has increased rapidly in recent years.
  • It is valuable in primary staging of untreated advanced cervical cancer, for posttreatment unexplained tumor marker elevation and restaging of potentially curable recurrent cervical cancer.
  • Its value in early-stage cervical cancer is limited.
  • In ovarian cancer, sequential imaging predicts response to neoadjuvant chemotherapy and survival.
  • It also provides benefits when increases in serum CA 125 or computed tomography/magnetic resonance imaging defined recurrence is noted but biopsy deemed infeasible.
  • A few studies have shown that FDG-PET may facilitate optimal management of endometrial cancer, especially for posttherapy surveillance and after salvage therapy.
  • FDG-PET is potentially useful in selected gestational trophoblastic neoplasia by monitoring response and localizing viable tumors after chemotherapy.
  • Scanty studies have been reported in vulvar and vaginal cancer.
  • The methodology and prospects of using integrated PET/computed tomography in the management of gynecological cancer are discussed.
  • SUMMARY: The role of PET or PET/computed tomography has evolved from a diagnostic tool into a potential indicator of response to treatment and prognosis.
  • [MeSH-major] Endometrial Neoplasms / radionuclide imaging. Ovarian Neoplasms / radionuclide imaging. Positron-Emission Tomography. Uterine Cervical Neoplasms / radionuclide imaging

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  • (PMID = 17218850.001).
  • [ISSN] 1040-872X
  • [Journal-full-title] Current opinion in obstetrics & gynecology
  • [ISO-abbreviation] Curr. Opin. Obstet. Gynecol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 53
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24. Edelweiss M, Malpica A: Dermatofibrosarcoma protuberans of the vulva: a clinicopathologic and immunohistochemical study of 13 cases. Am J Surg Pathol; 2010 Mar;34(3):393-400
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  • [Title] Dermatofibrosarcoma protuberans of the vulva: a clinicopathologic and immunohistochemical study of 13 cases.
  • Dermatofibrosarcoma protuberans (DFSP) is a low-grade sarcoma seldom seen in the vulva with only 29 cases reported.
  • Twelve patients had a vulvar mass.
  • One patient also developed distant metastases.
  • All recurrences were treated surgically; 1 patient also received chemotherapy and radiotherapy and another received imatinib (Gleevec).
  • The frequent expression of PDGFR-alpha, PDGFR-beta, and c-abl in these cases agrees with the findings of other investigators and supports the use of imatinib (Gleevec) in cases that are recurrent or not amenable to surgery.
  • [MeSH-major] Biomarkers, Tumor / analysis. Dermatofibrosarcoma / diagnosis. Immunohistochemistry. Skin Neoplasms / diagnosis. Vulvar Neoplasms / diagnosis
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Diagnosis, Differential. Female. Gynecologic Surgical Procedures. Humans. Middle Aged. Neoplasm Recurrence, Local. Predictive Value of Tests. Radiotherapy, Adjuvant. Reoperation. Time Factors. Treatment Outcome. Young Adult

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  • (PMID = 20139758.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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25. Han SC, Kim DH, Higgins SA, Carcangiu ML, Kacinski BM: Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva. Int J Radiat Oncol Biol Phys; 2000 Jul 15;47(5):1235-44
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  • [Title] Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva.
  • PURPOSE: To determine the impact of primary or adjuvant chemotherapy and radiation (CRT) on the survival rates of patients with locally advanced vulvar carcinoma.
  • METHODS AND MATERIALS: Between 1973 and 1998, 54 patients with vulvar cancer were treated with radiation therapy, among which 20 received CRT, while 34 patients received radiation therapy (RT) alone.
  • Of the 20 patients, 14 were treated for primary or recurrent disease (pCRT), and 6 after radical vulvectomy for high-risk disease (aCRT).
  • Of the 34 patients, 12 were treated primarily (pRT) and 22 received adjuvant treatment (aRT).
  • Chemotherapy consisted of 2 courses of 5-fluorouracil (5-FU) and mitomycin C administered during RT.
  • In CRT groups, radiation was administered to the vulva, pelvic, and inguinal lymph nodes to a median dose of 45 Gy with additional 6-17 Gy to gross disease.
  • In RT groups, the median dose to the microscopic diseases was 45 Gy.
  • CONCLUSION: Concurrent radiation therapy and chemotherapy decreases local relapse rate, improves disease-specific and overall survival over RT alone as primary treatment for locally advanced vulvar cancer.
  • [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] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Middle Aged. Mitomycin / administration & dosage. Neoplasm Staging. Radiotherapy Dosage. Vulva / surgery

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  • (PMID = 10889377.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-47292; United States / NCI NIH HHS / CA / CA-74832
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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26. Blake P: Radiotherapy and chemoradiotherapy for carcinoma of the vulva. Best Pract Res Clin Obstet Gynaecol; 2003 Aug;17(4):649-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiotherapy and chemoradiotherapy for carcinoma of the vulva.
  • Radiotherapy may be used in the treatment of vulval cancer as an alternative to surgery in unfit patients, as an adjuvant to surgery in patients with poor prognosis tumours and for the treatment of inoperable, recurrent and metastatic disease.
  • This chapter presents the historical development of radiotherapy for vulval cancer, the role of radiotherapy in the treatment of the primary tumour and also the loco-regional nodes, both for prophylaxis and for proven node metastasis.
  • Techniques for delivering radiotherapy are then discussed and are followed by protocols detailing radiotherapy and chemotherapy doses for different clinical situations.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Brachytherapy. Chemotherapy, Adjuvant. Female. Humans. Inguinal Canal. Lymphatic Metastasis. Neoadjuvant Therapy. Radiotherapy, High-Energy

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  • (PMID = 12965137.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 25
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27. 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.
  • 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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28. Hensley ML: Uterine/female genital sarcomas. Curr Treat Options Oncol; 2000 Jun;1(2):161-8
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  • Prognosis and treatment vary greatly depending on specific histology, grade, and tumor stage.
  • It is frequently used as adjuvant therapy for resected high-grade or margin-positive vulvo-vaginal sarcomas, and for endometrial stromal sarcomas.
  • Adjuvant chemotherapy has not been demonstrated to improve survival in vulvo-vaginal sarcomas, with the exception of vulvo-vaginal rhabdomyosarcomas, nor has it been demonstrated to improve survival in uterine sarcomas.
  • Chemotherapy may be used for recurrent or persistent disease.
  • The choice of agent depends on the histologic type of sarcoma.
  • [MeSH-major] Sarcoma / therapy. Uterine Neoplasms / therapy. Vaginal Neoplasms / therapy. Vulvar Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Female. Humans. Prognosis. Radiotherapy, Adjuvant. Survival Rate

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  • (PMID = 12057054.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 44
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29. Fleisch MC, Pantke P, Beckmann MW, Schnuerch HG, Ackermann R, Grimm MO, Bender HG, Dall P: Predictors for long-term survival after interdisciplinary salvage surgery for advanced or recurrent gynecologic cancers. J Surg Oncol; 2007 May 1;95(6):476-84

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  • [Title] Predictors for long-term survival after interdisciplinary salvage surgery for advanced or recurrent gynecologic cancers.
  • BACKGROUND AND OBJECTIVES: We wanted to identify factors which allow predicting long-term survival after pelvic exenteration (PE) for locally advanced or recurrent gynecologic malignancies.
  • PE was performed for locally advanced (36%) or recurrent (64%) cervical (n = 133), endometrial (n = 26), vaginal (n = 23), vulvar (n = 10), and ovarian cancer (n = 11, cases with rectum and/or bladder resections).
  • In 13.4% (n = 26) the intent of the procedure was palliation in the remaining cure.
  • 53% of patients underwent preoperative radio-chemotherapy, 11.8% as a neoadjuvant treatment.
  • Mean OR time was 8.1 hr, an average of 5.6 units of packed red blood cells were perioperatively transfused.
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Endometrial Neoplasms / mortality. Endometrial Neoplasms / surgery. Female. Humans. Kaplan-Meier Estimate. Middle Aged. Ovarian Neoplasms / mortality. Ovarian Neoplasms / surgery. Survival Rate. Survivors. Uterine Cervical Neoplasms / mortality. Uterine Cervical Neoplasms / surgery. Vaginal Neoplasms / mortality. Vaginal Neoplasms / surgery. Vulvar Neoplasms / mortality. Vulvar Neoplasms / surgery

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  • [Copyright] Copyright 2007 Wiley-Liss, Inc.
  • (PMID = 17192947.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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30. Montana GS, Thomas GM, Moore DH, Saxer A, Mangan CE, Lentz SS, Averette HE: Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study. Int J Radiat Oncol Biol Phys; 2000 Nov 1;48(4):1007-13
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  • [Title] Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study.
  • PURPOSE: To determine if patients with carcinoma of the vulva, with N2/N3 lymph nodes, could undergo resection of the lymph nodes and primary tumor following preoperative chemo-radiation.
  • Patients underwent a split course of radiation, 4760 cGy to the primary and lymph nodes, with concurrent chemotherapy, cisplatin/5-FU, followed by surgery.
  • RESULTS: Four patients did not complete the chemo-radiation, because three expired and one refused to complete the treatment.
  • Four patients who completed chemo-radiation did not undergo surgery, because two of them died of non-cancer-related causes, and in the other two patients, the nodes remained unresectable.
  • Nineteen patients developed recurrent and/or metastatic disease.
  • Two patients died of treatment-related complications.
  • CONCLUSION: High resectability and local control rates of the lymph nodes were obtained in patients with carcinoma of the vulva with N2/N3 nodes treated preoperatively with chemo-radiation.
  • [MeSH-major] Carcinoma / drug therapy. Carcinoma / radiotherapy. Lymph Node Excision. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Groin. Humans. Lymphatic Metastasis / pathology. Middle Aged. Neoplasm Staging. Treatment Failure

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  • (PMID = 11072157.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 37517; United States / NCI NIH HHS / CA / CA27469
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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31. Hou JL, Wu LY, Zhang HT, Li N, Yu GZ: [Clinicopathological characteristics of six patients with adenoid cystic carcinoma of the Bartholin gland]. Zhonghua Zhong Liu Za Zhi; 2010 Apr;32(4):290-3
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  • [Title] [Clinicopathological characteristics of six patients with adenoid cystic carcinoma of the Bartholin gland].
  • OBJECTIVE: To evaluate the clinicopathological characteristics and treatment of adenoid cystic carcinoma of the Bartholin gland.
  • METHODS: The clinicopathological data of six patients with adenoid cystic carcinoma of the Bartholin gland were retrospectively analyzed.
  • Surgery was the primary treatment.
  • Simple vulvar tumor resection was performed in 1 patient.
  • Four cases underwent radical vulvectomy with bilateral inguinal lymph node dissection and 1 case underwent wide local excision of the vulva with bilateral inguinal lymph node biopsy.
  • Cribriform arrangement of tubules and gland-like elements and infiltration of perineural spaces were two main microscopic features of this type of tumor.
  • Recurrence developed in 4 cases including 3 with both local recurrence and lung metastasis, and one had lung metastasis only.
  • The other 3 recurrent patients survived with tumor and the total survival period was 241, 128 and 103 months, respectively.
  • CONCLUSION: Adenoid cystic carcinoma of the Bartholin gland is a slow growing but locally very aggressive neoplasm with a high capacity for local recurrence and lung metastasis.
  • Surgery is the most common and useful treatment.
  • Radiation is a choice of treatment for patients with high risk factors after surgery such as positive surgical margin, deep local invasion and infiltration of perineural spaces or for recurrent patients without opportunity of excision.
  • [MeSH-major] Bartholin's Glands / pathology. Carcinoma, Adenoid Cystic / surgery. Vulva / surgery. Vulvar Neoplasms / surgery
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Lung Neoplasms / secondary. Lung Neoplasms / surgery. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Recurrence, Local / surgery. Radiotherapy, High-Energy. Retrospective Studies. Survival Rate

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  • (PMID = 20510082.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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32. Husain A, Akhurst T, Larson S, Alektiar K, Barakat RR, Chi DS: A prospective study of the accuracy of 18Fluorodeoxyglucose positron emission tomography (18FDG PET) in identifying sites of metastasis prior to pelvic exenteration. Gynecol Oncol; 2007 Jul;106(1):177-80
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  • [Title] A prospective study of the accuracy of 18Fluorodeoxyglucose positron emission tomography (18FDG PET) in identifying sites of metastasis prior to pelvic exenteration.
  • PURPOSE: To determine the accuracy of (18)FDG PET in identifying sites of metastatic disease prior to pelvic exenteration or radical resection in patients (pts) with recurrent cervical or vaginal cancers.
  • METHODS: Pts with recurrent cervical or vaginal cancer being evaluated for surgical resection were enrolled in a prospective study approved by the institutional human subjects review board.
  • All pts had undergone prior pelvic radiation therapy and five patients had also received chemotherapy.
  • [MeSH-minor] Adult. Aged. Female. Humans. Magnetic Resonance Imaging. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radionuclide imaging. Neoplasm Recurrence, Local / surgery. Pelvic Exenteration. Positron-Emission Tomography / methods. Positron-Emission Tomography / standards. Prospective Studies. Tomography, X-Ray Computed. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / radionuclide imaging. Uterine Cervical Neoplasms / surgery. Vaginal Neoplasms / pathology. Vaginal Neoplasms / radionuclide imaging. Vaginal Neoplasms / surgery. Vulvar Neoplasms / pathology. Vulvar Neoplasms / radionuclide imaging. Vulvar Neoplasms / surgery

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  • (PMID = 17477959.001).
  • [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] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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33. Chase DM, Basu T, Saffari B, Ries S, Berman ML: Malignant eccrine spiradenoma of the vulva: a case report and review of the literature. Int J Gynecol Cancer; 2006 May-Jun;16(3):1465-9
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  • [Title] Malignant eccrine spiradenoma of the vulva: a case report and review of the literature.
  • She had an 18-month history of a recurrent, painful mass adjacent to the clitoris.
  • As malignant eccrine spiradenoma is a rare tumor, no standard care exists for treatment and postoperative management.
  • Based on our review of the literature, wide local excision appears to be the preferred initial treatment.
  • Furthermore, adjuvant chemotherapy and/or radiation does not seem to improve survival in patients with advanced or recurrent cancer.
  • Although lymph node sampling and/or lymphadenectomy is frequently reported in the treatment of this tumor, hematogenous metastasis can also occur.
  • Therefore, these patients require close postoperative follow-up for recurrent disease.
  • [MeSH-major] Acrospiroma / diagnosis. Sweat Gland Neoplasms / diagnosis. Vulvar Neoplasms / diagnosis

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  • (PMID = 16803551.001).
  • [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] 13
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