RT Journal Article
SR Electronic
T1 Chemoradiation in Advanced Vulval Carcinoma
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 745-751
OP 745-751
DO 10.1111/IGC.0b013e3181a13021
VO 19
IS 4
A1 Linda J. Rogers
A1 Bruce Howard
A1 Leon Van Wijk
A1 Wenbin Wei
A1 Katrien Dehaeck
A1 Robbert Soeters
A1 Lynette A. Denny
YR 2009
UL http://ijgc.bmj.com/content/19/4/745-751.abstract
AB Introduction: Vulval carcinoma is uncommon, affecting approximately 2 per 100,000 women annually. The treatment of choice is radical vulvectomy and inguinal lymph node dissection.Advanced vulval carcinomas involve midline structures (such as clitoris, urethra, or anus) and/or adjacent pelvic organs or bone, and adequate excision may require urinary diversion, colostomy, or pelvic exenteration. Less morbid and less mutilating therapeutic alternatives have been investigated, particularly chemoradiation, which has shown success in the management of anal carcinomas.Chemoradiation has been used, instead of primary radical surgery, to treat advanced vulval carcinomas at Groote Schuur Hospital (GSH) since 1982. This is a retrospective study of the GSH's experience of the use of chemoradiation as primary therapy for women with advanced vulval carcinoma.Methods: Data from patients' medical records were transcribed onto a standardized pro forma, computerized, and analyzed.Results: Between 1982 and 2001, 50 women with advanced vulval carcinomas were treated with chemoradiation at GSH. Fourteen women (28%) who had a complete response to chemoradiation had significantly improved survival compared with 29 (58%) who had a partial response (P = 0.000218). Partial responders who had surgery had significantly better survival than those who did not (P = 0.0064). Other prognostic factors for survival were performance status and tumor stage.Conclusions: Less than a third of the women treated with primary chemoradiation had a complete response. Survival was improved in women who responded partially but had residual disease surgically excised. Performance status, age, and tumor stage were also associated with survival.