Conservative Management of Vulvar Cancer—Where Should We Draw the Line?
Abstract
:Simple Summary
Abstract
1. Introduction
Historical Perspectives
2. Morbidity
2.1. Measures to Decrease the Acute Morbidity of Wound Closure and Healing
2.2. Measures to Decrease Lower Limb Lymphedema
2.2.1. Elimination of Pelvic Lymph Node Dissection
2.2.2. Modification of the Inguino-Femoral Lymphadenectomy
2.2.3. Sentinel Lymph Node Biopsy
2.3. Measures to Decrease Psychosexual Morbidity by Vulvar Conservation
3. Types of Local Recurrence
3.1. Controversies Regarding Surgical Margins
3.2. Field Cancerization
4. Conclusions
5. Future Directions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Modification | Effect on Survival |
---|---|
Elimination of pelvic lymphadenectomy [10,13,14,15,16] | Nil |
No LND for cancer ≤ 2 cm diameter with ≤5 mm invasion [16] | Decreased |
“Superficial” groin dissection [17] | Decreased |
Radiation instead of groin dissection [18] | Decreased |
Use of separate groin incisions [7,19,20] | Nil |
Unilateral groin LND for lateral lesions [21,22] | Nil |
RLE for lesions ≤ 2 cm diameter [17,22,23] | Nil |
I cm surgical margins for unifocal cancers [24] | Nil |
RLE for all unifocal lesions [25,26] | Nil |
Nodal debulking instead of full groin LND [27,28,29] | Nil |
Selective sentinel node biopsy [30] | Small decrease |
Selective SNB + ultrasonic surveillance of sentinel node negative groins [31] | Nil |
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Hacker, N.F.; Barlow, E.L. Conservative Management of Vulvar Cancer—Where Should We Draw the Line? Cancers 2024, 16, 2991. https://doi.org/10.3390/cancers16172991
Hacker NF, Barlow EL. Conservative Management of Vulvar Cancer—Where Should We Draw the Line? Cancers. 2024; 16(17):2991. https://doi.org/10.3390/cancers16172991
Chicago/Turabian StyleHacker, Neville F., and Ellen L. Barlow. 2024. "Conservative Management of Vulvar Cancer—Where Should We Draw the Line?" Cancers 16, no. 17: 2991. https://doi.org/10.3390/cancers16172991