T2/3 vulva cancer

A case-control study of triple incision versus en bloc radical vulvectomy and inguinal lymphadenectomy

Barry S. Siller, Ronald D. Alvarez, Wendy D. Conner, Carol H. McCullough, Larry Kilgore, Edward E. Partridge, J. Max Austin

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

The purpose of this case-control study was to compare outcome in T2/3 vulvar cancer patients treated with radical vulvectomy and inguinal lymphadenectomy using either a triple incision or en bloc technique. All T2/3 vulvar cancer patients treated by the triple incision technique were identified and compared to a control group consisting of similar T2/3 patients treated with an en bloc procedure at the same institution. Survival by surgical stage, lesion diameter, nodal status, and margin status was analyzed and compared between the two groups. Twenty-seven vulvar cancer patients with a T2/3 lesion underwent radical vulvectomy and inguinal lymphadenectomy using the triple incision technique; the control group consisted of 20 T2/3 vulvar cancer patients treated by en bloc resection. The two groups were matched for age, surgical stage, grade, lesion diameter, margin status, nodal status, and adjuvant treatment. The recurrence rate in the triple incision group was 37% compared to 35% in the en bloc group. (OR, 1.092, 95% CI, (0.327, 3.649), P = 0.9) There was no difference in the local recurrence rate between the two groups (80% in the triple incision group and 72% in the en bloc group) (P = 0.5). Five-year survival for the triple incision and the en bloc groups was similar, 64 and 82%, respectively (P = 0.15). Survival between the groups was not statistically different when analyzed according to surgical stage, lesion diameter, nodal status, and negative margin status. These data indicate that the triple incision technique provides survival outcomes similar to the standard en bloc radical vulvectomy in patients with T2/3 vulva cancer. Due to the significant morbidity that has been associated with the en bloc radical vulvectomy and inguinal lymphadenectomy, the triple incision technique should be considered as the preferred method of treatment for most vulvar cancer patients.

Original languageEnglish (US)
Pages (from-to)335-339
Number of pages5
JournalGynecologic oncology
Volume57
Issue number3
DOIs
StatePublished - Jan 1 1995

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Vulvar Neoplasms
Groin
Lymph Node Excision
Case-Control Studies
Survival
Recurrence
Control Groups
Research Design
Morbidity
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

T2/3 vulva cancer : A case-control study of triple incision versus en bloc radical vulvectomy and inguinal lymphadenectomy. / Siller, Barry S.; Alvarez, Ronald D.; Conner, Wendy D.; McCullough, Carol H.; Kilgore, Larry; Partridge, Edward E.; Austin, J. Max.

In: Gynecologic oncology, Vol. 57, No. 3, 01.01.1995, p. 335-339.

Research output: Contribution to journalArticle

Siller, Barry S. ; Alvarez, Ronald D. ; Conner, Wendy D. ; McCullough, Carol H. ; Kilgore, Larry ; Partridge, Edward E. ; Austin, J. Max. / T2/3 vulva cancer : A case-control study of triple incision versus en bloc radical vulvectomy and inguinal lymphadenectomy. In: Gynecologic oncology. 1995 ; Vol. 57, No. 3. pp. 335-339.
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abstract = "The purpose of this case-control study was to compare outcome in T2/3 vulvar cancer patients treated with radical vulvectomy and inguinal lymphadenectomy using either a triple incision or en bloc technique. All T2/3 vulvar cancer patients treated by the triple incision technique were identified and compared to a control group consisting of similar T2/3 patients treated with an en bloc procedure at the same institution. Survival by surgical stage, lesion diameter, nodal status, and margin status was analyzed and compared between the two groups. Twenty-seven vulvar cancer patients with a T2/3 lesion underwent radical vulvectomy and inguinal lymphadenectomy using the triple incision technique; the control group consisted of 20 T2/3 vulvar cancer patients treated by en bloc resection. The two groups were matched for age, surgical stage, grade, lesion diameter, margin status, nodal status, and adjuvant treatment. The recurrence rate in the triple incision group was 37{\%} compared to 35{\%} in the en bloc group. (OR, 1.092, 95{\%} CI, (0.327, 3.649), P = 0.9) There was no difference in the local recurrence rate between the two groups (80{\%} in the triple incision group and 72{\%} in the en bloc group) (P = 0.5). Five-year survival for the triple incision and the en bloc groups was similar, 64 and 82{\%}, respectively (P = 0.15). Survival between the groups was not statistically different when analyzed according to surgical stage, lesion diameter, nodal status, and negative margin status. These data indicate that the triple incision technique provides survival outcomes similar to the standard en bloc radical vulvectomy in patients with T2/3 vulva cancer. Due to the significant morbidity that has been associated with the en bloc radical vulvectomy and inguinal lymphadenectomy, the triple incision technique should be considered as the preferred method of treatment for most vulvar cancer patients.",
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