Medicinski pregled 2012 Volume 65, Issue 3-4, Pages: 97-101
https://doi.org/10.2298/MPNS1204097P
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Surgical treatment of invasive vulvar cancer
Pantelić Miloš (Clinical Center of Vojvodina, Department of Gynecology and Obstetrics, Novi Sad)
Đurđević Srđan (Clinical Center of Vojvodina, Department of Gynecology and Obstetrics, Novi Sad)
Nikolić Dragan (Clinical Center of Vojvodina, Department of Vascular and Transplantation Surgery, Novi Sad)
Maksimović Marko (Clinical Center of Vojvodina, Department of Gynecology and Obstetrics, Novi Sad)
This paper presents the surgical treatment of invasive cancer of the vulva at
the Department of Gynecology and Obstetrics in Novi Sad in the period from
2000 to 2010. Forty-one patients underwent different surgical procedures
depending on their stage of the disease, age and general physical condition
assessed according to the International Federation of Gynecologists and
Obstetricians: wide excision to the healthy area with negative edges of 10
mm, simplex - radical vulvectomy or hemivulvectomy, block dissection of the
vulva by Way, one-sided or bilateral lymphadenectomy and skin-muscle flap to
cover the resulting skin defects. The number of removed lymph nodes on one
side ranged from 8 to 19, the average being 12.6. Various postoperative
complications (inflammation and wound dehiscence, lymphorrhoea, lymphocyst
and limb lymphedema) developed in 9 (21.9%) and the local regional recurrence
was recorded in 7 (17%) patients. The outcome was lethal in 4 (9.8%)
surgically treated women. The primary surgical procedure is always
individually planned and the choice of individual plans depends on three main
factors: the size and position of the primary tumor in relation to the center
line of the vulva (clitoral area - anus) and the involvement of regional
lymph nodes. In order to reduce the psychosexual morbidity the preference is
nowadays widely given to the local excision with adequate and
histopathologically confirmed negative edges of the tumor together with
determining the presence of metastases in sentinel lymph nodes.
Keywords: Vulvar Neoplasms, Surgical Procedures, Operative + methods, Female, Neoplasm Staging, Postoperative Complications, Mortality, Lymph Node Excision, Sentinel Lymph Node Biopsy