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Surgical management of squamous cell vulvar cancer without clitoris, urethra or anus involvement

机译:无阴蒂,尿道或肛门受累的鳞状细胞外阴癌的外科治疗

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Vulvar cancers, which constitute 5% of all gynecologic cancers, are the fourth most common female genital cancers, preceded by uterine, ovarian and cervical cancers. The treatment methods employed for vulvar cancers have changed over the years, with previously applied radical surgical approaches, such as en bloc resection, being gradually suspended in favor of treatment approaches that require dissection of less tissue. While the removal of less tissue, which today's approaches have focused on, prevents morbidity, this method seems to result in higher risks of recurrence. It is therefore important that the balance between preventing the recurrence of the disease and forefending against postoperative complications and vulvar deformity be properly understood. As a working assumption, if patients with vulvar cancer are diagnosed at an early stage, properly evaluated and administered appropriate treatment, the most positive results can be obtained. This paper aims to highlight this assumption and demonstrate, through the provision of actual data, how to plan the treatment approach for patients who are diagnosed early. Statements extracted from the National Comprehensive Cancer Network (NCCN) Guidelines Version 1.2016 Sub-Committees on vulvar squamous cell carcinoma and articles by the European Society of Gynaecological Oncology (ESGO) regarding Vulvar Cancer Recommendations were used to obtain updated information. Highlights ? Radical/wide local excision is an alternative to radical vulvectomy in selected patients. ? The aim of the tumor resection should be to achieve the adequate surgical border. ? Complete inguinofemoral lymphadenectomy is more advantageous in terms of recurrence. ? Recurrence is a particularly problematic feature of vulvar cancer cases. ? Saphenous vein preservation is contradictory, preservation is maybe more advantageous.
机译:外阴癌占所有妇科癌症的5%,是第四大最常见的女性生殖器癌,其次是子宫癌,卵巢癌和宫颈癌。多年来,用于外阴癌的治疗方法发生了变化,以前应用的彻底外科手术方法(例如整块切除术)逐渐暂停使用,有利于需要解剖更少组织的治疗方法。尽管当今方法关注的是切除较少的组织可以防止发病,但是这种方法似乎导致更高的复发风险。因此,重要的是要正确理解预防疾病复发与预防术后并发症和外阴畸形之间的平衡。作为可行的假设,如果在早期诊断出外阴癌患者,对其进行适当评估并给予适当治疗,则可以获得最积极的结果。本文旨在突出这一假设,并通过提供实际数据来演示如何为早期诊断的患者规划治疗方案。摘录自国家综合癌症网络(NCCN)指南版本1.2016分委员会关于外阴鳞状细胞癌的声明以及欧洲妇科肿瘤学会(ESGO)关于外阴癌建议的文章,以获取最新信息。强调 ?根治性/广泛局部切除术是某些患者根治性外阴切除术的替代方法。 ?肿瘤切除的目的应该是获得足够的手术边界。 ?就复发而言,完全腹股沟股沟淋巴结清扫术更有利。 ?复发是外阴癌病例特别有问题的特征。 ?大隐静脉的保存是矛盾的,保存可能更有利。

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