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首页> 外文期刊>Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology >Carcinoma of the vulva: a retrospective review of 37 cases at a regional cancer centre in South India.
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Carcinoma of the vulva: a retrospective review of 37 cases at a regional cancer centre in South India.

机译：外阴癌：回顾印度南部地区癌症中心的37例病例。

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摘要

A retrospective review of 37 cases of carcinoma of the vulva presenting between 1996 and 2000 has been carried out. Thirty-three cases were managed with curative intent and four cases with advanced loco-regional disease were managed with palliative intent. 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. Eight cases had a partial response and one case achieved complete response; the surgical margins were free in all these patients. One case received neoadjuvant radiotherapy to the vulva and pelvis followed by RV + BGND, which revealed no residual tumour. Overall, 26/33 cases had groin/inguinal node dissection and 23 (88.4%) of them had groin wound dehiscence. Thirteen of these 26 patients (50%) had inguinal node metastases (Stage III, four patients; Stage IV, nine patients). All the patients with negative nodes were free of disease while three of four patients with Stage III and two of nine patients with Stage IV with nodal metastases remained free of disease. The only patient with Stage III disease plus inguinal node metastases who recurred had multiple positive nodes with extracapsular spread. It appears that although bilateral involvement of the inguinal lymph nodes carries a worse prognosis, unilateral involvement with or without vaginal involvement carries an excellent prognosis provided multiple nodes are not involved. The role of neoadjuvant chemotherapy as compared to neoadjuvant radiotherapy, in locally advanced tumours, needs to be explored further.
机译：回顾性分析了1996年至2000年间出现的37例外阴癌病例。 33例采用治愈性治疗，4例晚期局部区域性疾病采用姑息治疗。手术治疗包括广泛切除1例，根治性外阴切除术（RV）6例，根治性外阴切除术和双侧腹股沟淋巴结清扫术（RV + BGND）25例，根治性外阴切除术和单侧腹股沟淋巴结清扫术1例。这33名妇女中有9名在术前也接受了辅助化疗，以期获得更好的无肿瘤手术切缘。 8例有部分缓解，1例完全缓解。所有这些患者的手术切缘都是免费的。 1例接受外阴和骨盆的新辅助放疗，其次是RV + BGND，未发现残留肿瘤。总体上，有26/33例行腹股沟/腹股沟淋巴结清扫术，其中23例（88.4％）发生了腹股沟裂开。这26例患者中有13例（50％）发生了腹股沟淋巴结转移（III期，4例; IV期，9例）。所有具有阴性淋巴结转移的患者均无疾病，而四分之三的III期患者和三分之九的四期有淋巴结转移的患者仍无疾病。唯一复发的III期疾病加腹股沟淋巴结转移的患者具有多个阳性淋巴结并有囊外扩散。似乎尽管腹股沟淋巴结的双侧受累预后较差，但如果不累及多个淋巴结，则单侧受累有或无阴道受累的预后都很好。与新辅助放疗相比，新辅助化疗在局部晚期肿瘤中的作用有待进一步研究。

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