Pelvic Exenteration for Recurrent Vulvar Cancer: A Retrospective Study.

Autor: Classen-von Spee, Sabrina, Baransi, Saher, Fix, Nando, Rawert, Friederike, Luengas-Würzinger, Verónica, Lippert, Ruth, Bonin-Hennig, Michelle, Mallmann, Peter, Lampe, Björn
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Zdroj: Cancers; Jan2024, Vol. 16 Issue 2, p276, 17p
Abstrakt: Simple Summary: Almost half of patients with vulvar cancer develop a recurrence after primary surgical treatment. There is no clear recommendation for treatment, especially in advanced cases. Data for chemotherapy/radio(chemo)therapy are rare, with moderate to poor response rates and overall survival. Additionally, due to radiation within the primary treatment, radio(chemo)therapy is usually not a possible treatment method. Hence, pelvic exenteration (PE) might be the only choice for curation, with good overall survival and moderate morbidity. PE showed improved quality of life, even in palliative situations, especially in cases of cloacas or urogenital/intestinal fistulas. There are only a few studies analysing PE in vulvar cancer exclusively, and none of them are dealing with recurrent cases separately. Due to this, we analysed 17 cases of recurrent vulvar cancer that underwent PE in our department. The aim was to identify relevant histopathological and clinical factors for overall survival. To further analyse PE for recurrent vulvar cancer, a comparison with the existing literature on PE and radio(chemo)therapy in recurrent vulvar cancer has been performed. Pelvic exenteration (PE) is one of the most radical surgical approaches. In earlier times, PE was associated with high morbidity and mortality. Nowadays, due to improved selection of suitable patients, perioperative settings, and postoperative care, patients' outcomes have been optimized. To investigate patients' outcomes and identify possible influencing clinical and histopathological factors, we analysed 17 patients with recurrent vulvar cancer who underwent PE in our department between 2007 and 2022. The median age was 64.9 years, with a difference of 40 years between the youngest and the oldest patient (41 vs. 81 years). The mean overall survival time was 55.7 months; the longest survival time reached up to 164 months. The achievement of complete cytoreduction (p = 0.02), the indication for surgery (curative vs. palliative), and the presence of distant metastases (both p = 0.01) showed a significant impact on overall survival. The presence of lymphatic metastases (p = 0.11) seems to have an influence on overall survival (OS) time. Major complications appeared in 35% of the patients. Our results support the existing data for PE in cases of recurrent vulvar cancer; for a group of selected patients, PE is a treatment option with good overall survival times and acceptable morbidity. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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