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1. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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.
  • Nine patients had squamous lesions, four patients had melanoma, and one patient had Paget's disease with stromal invasion.
  • Postoperatively, seven patients underwent no further treatment, six underwent radiation therapy, and one patient underwent chemotherapy.
  • Nine of 32 (22%) squamous lesions recurred, four (57%) of seven melanomas recurred, and the sole patient with invasive Paget's recurred.
  • 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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2. 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


3. Bellati F, Angioli R, Manci N, Angelo Zullo M, Muzii L, Plotti F, Basile S, Panici PB: Single agent cisplatin chemotherapy in surgically resected vulvar cancer patients with multiple inguinal lymph node metastases. Gynecol Oncol; 2005 Jan;96(1):227-31
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  • [Title] Single agent cisplatin chemotherapy in surgically resected vulvar cancer patients with multiple inguinal lymph node metastases.
  • OBJECTIVE: The aim of this study was to evaluate acute and long-term morbidity, recurrence rate, and overall survival in patients with multiple groin lymph node metastases treated with postoperative chemotherapy.
  • All patients completed the treatment.
  • No treatment-related deaths occurred.
  • Only two patients suffered from grade 4 neutropenia during chemotherapy.
  • CONCLUSIONS: In patients affected by vulvar cancer with multiple lymph node metastases, radical surgery followed by chemotherapy is a feasible strategy, with an acceptable short- and long-term complication rate.
  • Furthermore, due to absence of local long-term tissue toxicity, this strategy allows physicians to surgically treat regional lymph node recurrence safely.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Cisplatin / therapeutic use. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / surgery
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Lymph Node Excision. Lymph Nodes / pathology. Lymph Nodes / surgery. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local

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  • (PMID = 15589606.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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4. 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.
  • [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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5. 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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6. Montana GS: Carcinoma of the vulva: combined modality treatment. Curr Treat Options Oncol; 2004 Apr;5(2):85-95
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  • [Title] Carcinoma of the vulva: combined modality treatment.
  • One of the most significant developments in recent decades in the management of malignant diseases is the recognition that surgery, radiation, and chemotherapy have limited curative potential.
  • In addition, patients that could not be considered candidates for any treatment, such as patients with unresectable nodes, can be offered therapy with potential of cure.
  • The patients with moderately or very advanced disease should be considered for the combination of chemotherapy, radiation, and surgery.
  • This combined therapy results in better outcome with lesser morbidity.
  • The studies that have been carried out in recent years for patients with advanced carcinoma of the vulva have helped to establish treatment guidelines that can be followed with confidence until more information becomes available.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Vulvar Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Female. Gynecologic Surgical Procedures. Humans. Incidence. Neoplasm Invasiveness. Radiotherapy, Adjuvant

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  • (PMID = 14990203.001).
  • [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
  • [Number-of-references] 36
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7. Preti M, Micheletti L, Ghiringhello B, Privitera S, Condello V, Chieppa P, Massobrio M: [Vulvar Paget's disease. Clinico-pathologic review of the literature]. Minerva Ginecol; 2000 May;52(5):203-11
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  • [Title] [Vulvar Paget's disease. Clinico-pathologic review of the literature].
  • In 1986 the International Society For the Study of Vulvar Disease classified vulvar Paget's disease (VPD) as a non-squamous intraepithelial lesion of the vulva.
  • Therapy for intraepithelial VPD is wide and deep surgical resection comprising all the skin appendages.
  • When association with underlying invasive adenocarcinoma or stromal invasion is histologically confirmed, vulvar surgical approach must be integrated with inguino-femoral lymphadenectomy.
  • The role of chemotherapy and radiotherapy in the multimodal approach to extensive or recurring VPD is still controversial.
  • [MeSH-major] Paget Disease, Extramammary / pathology. Vulvar Neoplasms / pathology
  • [MeSH-minor] Female. Follow-Up Studies. Humans. Neoplasm Recurrence, Local. Neoplasms, Multiple Primary

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  • (PMID = 11048477.001).
  • [ISSN] 0026-4784
  • [Journal-full-title] Minerva ginecologica
  • [ISO-abbreviation] Minerva Ginecol
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] ITALY
  • [Number-of-references] 69
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8. 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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9. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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 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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10. 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.
  • Biopsy showed concomitant PV and vulvar intraepithelial neoplasia (VIN) grade 3.
  • Despite chemotherapy, no remission of disease was observed.
  • [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


11. Levgur M: Estrogen and combined hormone therapy for women after genital malignancies: a review. J Reprod Med; 2004 Oct;49(10):837-48
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  • [Title] Estrogen and combined hormone therapy for women after genital malignancies: a review.
  • This review summarizes information regarding estrogen therapy (ET) and hormone therapy (HT) for women with endometrial cancer as well as other gynecologic malignancies.
  • Of the 228 patients who received estrogen therapy, 3.5% developed recurrences as opposed to 16.5% among the 309 women receiving no therapy.
  • It is agreed, however, that the histologic type of the tumor is an important factor to consider prior to the initiation of such therapy.
  • Utilizing estrogen compounds has no bearing on risks of later developing squamous cell carcinoma of the cervix, or tubal, vulvar or vaginal cancer.
  • [MeSH-major] Genital Neoplasms, Female / pathology. Genital Neoplasms, Female / therapy. Hormone Replacement Therapy / adverse effects. Neoplasm Recurrence, Local / chemically induced
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adult. Age Factors. Aged. Aged, 80 and over. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Case-Control Studies. Continuity of Patient Care. Drug Therapy, Combination. Estrogen Replacement Therapy / adverse effects. Estrogen Replacement Therapy / methods. Female. Humans. Incidence. Middle Aged. Prognosis. Risk Assessment. Treatment Outcome

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  • (PMID = 15568410.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 75
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12. Bischoff A, Marnitz S, Köhler C, Kurzeja R, Morawietz L, Schneider A, Budach V: Complete remission after neoadjuvant chemoradiation in a stage IV vulvar cancer patient. Strahlenther Onkol; 2008 Aug;184(8):421-5
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  • [Title] Complete remission after neoadjuvant chemoradiation in a stage IV vulvar cancer patient.
  • BACKGROUND: Surgery is the standard in the management of vulvar cancer.
  • Several studies assessed the feasibility of radiochemotherapy as definitive therapy and/or neoadjuvant procedure in order to limit the extent of surgery.
  • The authors report on a modified neoadjuvant radiochemotherapy schedule which is isoeffective to the GOG (Gynecologic Oncology Group) protocol, but associated with less therapy-related toxicity.
  • CASE REPORT: A 36-year-old woman with stage IV vulvar cancer and long-distance rectal infiltration is reported.
  • After complete remission, a simple vulvectomy carried out 3 months later showed no evidence of tumor.
  • Up to now, there is no evidence of tumor progression or recurrence.
  • CONCLUSION: Preoperative conventionally fractionated simultaneous radiochemotherapy seems to be a feasible and safe treatment option for patients with locally advanced vulvar cancer in order to avoid exenterative surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Neoadjuvant Therapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Bowen's Disease / drug therapy. Bowen's Disease / pathology. Bowen's Disease / radiotherapy. Combined Modality Therapy. Female. Human papillomavirus 16. Humans. Lymph Nodes / pathology. Lymphatic Metastasis. Neoplasm Invasiveness. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Staging. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / pathology. Neoplasms, Multiple Primary / radiotherapy. Papillomavirus Infections / drug therapy. Papillomavirus Infections / pathology. Papillomavirus Infections / radiotherapy. Radiation Injuries / etiology. Rectum / pathology. Rectum / radiation effects. Skin Neoplasms / drug therapy. Skin Neoplasms / pathology. Skin Neoplasms / radiotherapy. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / radiotherapy. Vulva / pathology. Vulva / radiation effects. Vulva / surgery

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  • (PMID = 18956520.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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13. Stehman FB, Look KY: Carcinoma of the vulva. Obstet Gynecol; 2006 Mar;107(3):719-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The objective of this review is to summarize the published data about squamous carcinoma of the vulva and to identify promising areas for future investigation.
  • Rather than the routine use of complete radical vulvectomy, a radical wide excision of the vulvar lesion to achieve at least a 1-cm gross margin appears sufficient to treat the primary lesion.
  • All the nodal tissue medial to the vessels and above the fascia should be removed.
  • Patients with positive inguinal nodes at groin dissection should receive radiation therapy to the ipsilateral groin and hemipelvis.
  • Chemotherapy for recurrent or metastatic disease has not been proven to be of value.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Vulvar Neoplasms / therapy
  • [MeSH-minor] Female. Humans. Lymphatic Metastasis. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Postoperative Complications / epidemiology. Prognosis. Quality of Life

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  • (PMID = 16507947.001).
  • [ISSN] 1873-233X
  • [Journal-full-title] Obstetrics and gynecology
  • [ISO-abbreviation] Obstet Gynecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 168
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14. 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].
  • 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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15. 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.
  • The literature supports the use of 5-fluorouracil or cisplatin as single agents or in combination to have sensitivity against squamous cells.
  • [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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16. 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.
  • Epidermal growth factor receptor (EGFR) staining of the tumor cells showed 3+ staining in 100% of the cells.
  • 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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17. 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.
  • 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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18. 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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  • 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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19. 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.
  • 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.
  • 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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20. Di Benedetto G, Siquini W, Bertani A, Grassetti L: Vulvo-perineal reconstruction with a reverse sensitive rectus abdominis salvage flap in a multirecurrent anal carcinoma. J Plast Reconstr Aesthet Surg; 2010 Feb;63(2):e127-9
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  • We report a case of a patient affected by multirecurrent anal carcinoma, treated by chemotherapy, radiotherapy and surgery several times, until an extended abdominoperineal resection of Miles was performed.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Reconstructive Surgical Procedures / methods. Rectal Neoplasms / surgery. Surgical Flaps. Vulvar Neoplasms / surgery
  • [MeSH-minor] Female. Humans. Middle Aged. Neoplasm Recurrence, Local / surgery. Peritoneum / surgery

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  • [Copyright] 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • (PMID = 19631598.001).
  • [ISSN] 1878-0539
  • [Journal-full-title] Journal of plastic, reconstructive & aesthetic surgery : JPRAS
  • [ISO-abbreviation] J Plast Reconstr Aesthet Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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21. Gipponi M: Clinical applications of sentinel lymph-node biopsy for the staging and treatment of solid neoplasms. Minerva Chir; 2005 Aug;60(4):217-33
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  • [Title] Clinical applications of sentinel lymph-node biopsy for the staging and treatment of solid neoplasms.
  • A review of the clinical applications of sentinel lymph node (sN) biopsy has been performed with the aim of defining the rationale, the methods of detection, the accuracy, and the current indications to sN biopsy in different solid neoplasms.
  • In melanoma patients, sN biopsy represents a standard procedure for staging purpose, although its therapeutic value is still under examination.
  • In gynecologic malignancies, appreciable results are available in patients with vulvar and cervical cancer only.
  • Patients with squamous cell vulvar cancer may benefit by sN biopsy because a complete bilateral inguino-femoral lymph-node dissection may be avoided whenever the sN is free of metastasis.
  • The experience in urologic cancer deals mainly with penile and prostate cancer; the modern procedures for the dynamic detection of sN are going to clarify its role in the surgical management of penile cancer; as regards to prostate cancer, very preliminary results suggest that the sN biopsy may enhance the pathologic staging of this neoplasm compared to modified pelvic lymphadenectomy, due to the individual variability of the lymphatic drainage of this cancer.
  • In patients with clinically node-negative squamous head and neck cancer, the reliability of sN-guided neck lymph node dissection seems promising.
  • The sN biopsy is also technically feasible in patients with differentiated thyroid cancer; however, the future role of this procedure in the clinical decision-making of these patients remains to be defined due to the questionable biological meaning of nodal metastases.
  • Patients with non-small-cell lung cancer should be investigated by means of radiotracers injected at the time of thoracotomy or under CT-scan guidance in order to achieve a satisfactory identification rate (over 80%); the focused histopathologic staging of the sN improves current pathologic staging by conventional bi-valve assessment of all the lymph nodes of the surgical specimen; moreover, the prognostic role of isolated N2 metastasis can be better elucidated.
  • In patients with gastric cancer, current data show that it can be detected by means of peritumoral injection of indocyanine green; the detection of tumor positive lymph nodes beyond the perigastric area could select patients amenable to D2 lymphadenectomy.
  • As regards to colorectal cancer patients, the focused analysis of the sN may reveal disease that might otherwise go undetected by conventional surgical and pathological methods, and those patients which are upstaged can benefit by adjuvant chemotherapy.
  • Finally, in patients with Merkel cell carcinoma, notwithstanding the limited experiences with sN biopsy, sN histology seems to predict regional lymph node status and may aid in selecting which patients are amenable to therapeutic lymph node dissection.
  • [MeSH-minor] Breast Neoplasms / pathology. Breast Neoplasms / therapy. Female. Gastrointestinal Neoplasms / pathology. Gastrointestinal Neoplasms / therapy. Genital Neoplasms, Female / pathology. Genital Neoplasms, Female / therapy. Humans. Melanoma / pathology. Melanoma / therapy. Neoplasm Staging / methods

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  • (PMID = 16166921.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] eng; ita
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 99
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22. Vink SR, Schellens JH, van Blitterswijk WJ, Verheij M: Tumor and normal tissue pharmacokinetics of perifosine, an oral anti-cancer alkylphospholipid. Invest New Drugs; 2005 Aug;23(4):279-86
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  • [Title] Tumor and normal tissue pharmacokinetics of perifosine, an oral anti-cancer alkylphospholipid.
  • However, new interest has emerged since it was shown that these drugs enhance the cytotoxic effect of conventional chemotherapy and radiotherapy in preclinical models.
  • The aim of this study was to characterize the pharmacokinetic profile of perifosine, an oral analog of alkylphosphocholine (APC), and to compare in vitro drug uptake with in vivo drug accumulation in three human-derived squamous cell carcinomas (A431, HNXOE and KB).
  • Comparable tumor accumulation was observed for A431 and HNXOE tumors, whereas perifosine uptake by KB xenografts was substantially higher.
  • Tissue distribution occurred throughout the whole body reaching high perifosine levels in the gastro-intestinal tract, while heart and brain tissue contained relatively low levels.
  • Based on its stability and relatively high tumor uptake in vivo, perifosine is an attractive candidate for further evaluation, e.g. as radiosensitizer.
  • [MeSH-major] Antineoplastic Agents / pharmacokinetics. Carcinoma, Squamous Cell / metabolism. Head and Neck Neoplasms / metabolism. Phosphorylcholine / analogs & derivatives. Vulvar Neoplasms / metabolism
  • [MeSH-minor] Administration, Oral. Animals. Cell Line, Tumor. Cell Survival / drug effects. Female. Humans. Mice. Mice, Inbred BALB C. Mice, Nude. Neoplasm Transplantation. Tissue Distribution

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  • (PMID = 16012787.001).
  • [ISSN] 0167-6997
  • [Journal-full-title] Investigational new drugs
  • [ISO-abbreviation] Invest New Drugs
  • [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; 107-73-3 / Phosphorylcholine; 2GWV496552 / perifosine
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23. Bafna UD, Devi UM, Naik KA, Hazra S, Sushma N, Babu N: Carcinoma of the vulva: a retrospective review of 37 cases at a regional cancer centre in South India. J Obstet Gynaecol; 2004 Jun;24(4):403-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The surgical treatment consisted of wide excision in one case, radical vulvectomy (RV) in six cases, radical vulvectomy and bilateral groin node dissection (RV+BGND) in 25 cases and radical vulvectomy and unilateral groin node dissection in one case.
  • Nine of these 33 women also received adjuvant chemotherapy preoperatively in the hope of achieving better tumour-free surgical margins.
  • The role of neoadjuvant chemotherapy as compared to neoadjuvant radiotherapy, in locally advanced tumours, needs to be explored further.
  • [MeSH-major] Vulvar Neoplasms / epidemiology
  • [MeSH-minor] Adenocarcinoma / epidemiology. Adenocarcinoma / etiology. Adenocarcinoma / pathology. Adenocarcinoma / therapy. Adult. Aged. Carcinoma, Squamous Cell / epidemiology. Carcinoma, Squamous Cell / etiology. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Combined Modality Therapy. Female. Humans. India / epidemiology. Lymphatic Metastasis. Medical Records. Medically Underserved Area. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Palliative Care. Regional Medical Programs. Retrospective Studies

  • MedlinePlus Health Information. consumer health - Vulvar Cancer.
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  • (PMID = 15203581.001).
  • [ISSN] 0144-3615
  • [Journal-full-title] Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • [ISO-abbreviation] J Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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24. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • 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.
  • 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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