Article Text
Abstract
Introduction/Background Postoperative complications in vulvar cancer are the highest among gynaecological cancers. Studies have shown that postoperative complications occur in more than 50% of cases; the most important are wound dehiscence, lymph oedema and lymphocele. Sentinel node biopsy has reduced the number of systematic lymphadenectomies and, consequently, the frequency of lymph oedema and lymphocele.
Methodology It is a retrospective, observational study of a single tertiary-level centre performed between January 2016 and December 2019. Clinical data were gathered from the Division of Gynaecology and Obstetrics archive, University Medical Centre Ljubljana.
Results A total of 15 patients were treated with histologically verified advanced vulvar carcinoma. All cases were of squamous cell aetiology; five were HPV related, and ten were non-HPV-related. In regards to FIGO staging, 5 were stage II, 9 were stage III (1 IIIA, 1 IIIB and 7 IIIC), and one was stage IVB case. In all but one case, the surgical approach was radical vulvectomy with radical inguinal lymphadenectomy. Two cases required anus resection and stoma formation. Skin flaps were performed in a third of cases.
In all but 3 cases, postoperative complications were observed. Wound dehiscence was the most frequent, occurring in 66% of cases. The rate of wound infections was below 20%. In two cases, postoperative surgical revision was required due to wound hematoma and lymphocele. Hospitalisation time ranged from 5 to 34 days, with the majority between 12 and 24 days.
Conclusion Advanced vulvar cancer is a challenging disease, both from a surgical and postoperative standpoint. A dedicated and focused multidisciplinary team is required to provide the best care for mostly fragile, old and morbid patients. We find that hospitalisation time is very much a reflection of the care the patient can get after dismissal from the hospital.
Disclosures No disclosures.