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Turkish Journal of Cancer
1995, Volume 25, Number 1, Page(s) 34-41
[ Summary ]
Squamous cell carcinoma of the vulva
SANJAY DIXIT1, HARSHAD A. BABOO1, SANDEEP SINGHAL1, ANILA KAPADIA2, RAKESH K. VYAS1, JAYPRAKASH NEEMA1
Departments of 1Radiotherapy and 2Gynecology, The Gujarat Cancer and Research Institute, Asarwa-India

Sixty-eight cases of squamous cell carcinoma of the vulva, registered between 1985 to 1990 were analyzed. Thirty-three cases were treated by surgery and 11 cases were treated by radiotherapy alone. The remaining 24 cases were not available for analysis, due to postoperative death, no follow-up and incomplete treatment owing to poor general condition. Since 51% of cases presented in stage IVA, attemps were made to identify the factors influencing the presentation of cases in advanced stages. The duration of symptoms of swelling/ulcer over the genitalia significantly related with the presentation of cases in the early stage (T1+T2). However, age and the presence of pruritis and leukoplakia did not afect the presentation of disease in the early or advanced stage (T3+T4). Disease free survival (DFS) of 30 cases uniformally treated with radical vulvectomy and bilateral groin node dissection was 100% (2/2) for stage I, 91% (10/11) for stage II, 38% (5/13) for stage Ill and 0% (0/4) for stage IVA, with a mean follow-up of 29 months (range 12-50 months). Clitoris involvement and depth of invasion of more than 10 mm were found to be of poor prognostic value, while tumor grade and lymphatic involvement did not affect the DFS. With radiotherapy alone the two-year DFS was 18% (2/11), where all cases were in stage Ill or IVA. Considering the presentation and results in our set-up, down staging of disease through early detection of cases should be done by promoting self vulvar examination in cases having associated factors such as unexplained pruritus and leukoplakia, not only in elderly cases but also below 50 years of age, to increase the control rate, post operative radiotherapy would be needed in stage Ill and IVA and all cases with above mentioned poor prognostic factors.

[ Summary ]
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