Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.
Eur J Cancer Care (Engl). 2010 May;19(3):302-7. doi: 10.1111/j.1365-2354.2008.01011.x. Epub 2009 Aug 15.
The aim of the study was to investigate the management and outcome of inguinal recurrence in vulvar carcinoma patients. A retrospective chart review was conducted on 140 patients with squamous cell carcinoma of the vulva treated between 1994 and 2006. Twenty-one patients were found to have groin recurrence. Median interval between primary treatment of vulvar cancer and groin recurrence was 7 months. Three patients refused any treatment, 3 received chemotherapy, 2 inguino-pelvic radiotherapy and 13 had resection of the groin recurrence. After surgery seven patients received irradiation of the groin and pelvis, and three patients received chemotherapy. One patient died following surgery; 19 patients died of disease with the median survival after diagnosis of inguinal recurrence of 9 months. Only one patient is alive without evidence of disease at 60 months following surgery. In univariate analysis, stage and grade at diagnosis, age and performance status at the recurrent disease, and the extent of residual tumour after resection of groin recurrence were predictors for survival. Groin recurrences from vulvar carcinoma carry a poor prognosis. Multi-modal treatment may result in a palliation of the disease, and a very limited number of patients have long-term survival.
本研究旨在探讨外阴癌患者腹股沟复发的处理和预后。对 1994 年至 2006 年间收治的 140 例外阴鳞癌患者的病历进行回顾性分析。发现 21 例患者出现腹股沟复发。外阴癌初次治疗与腹股沟复发的中位间隔时间为 7 个月。3 例患者拒绝任何治疗,3 例接受化疗,2 例接受腹股沟-盆腔放疗,13 例接受腹股沟复发切除术。术后 7 例患者接受腹股沟和盆腔放疗,3 例患者接受化疗。1 例患者术后死亡,19 例患者死于疾病,诊断为腹股沟复发后中位生存时间为 9 个月。术后 60 个月仅 1 例患者无病存活。单因素分析显示,诊断时的分期和分级、复发时的年龄和身体状况、以及腹股沟复发切除术后的肿瘤残留范围是影响生存的预测因素。外阴癌的腹股沟复发预后不良。多模式治疗可能缓解疾病,极少数患者有长期生存。