Amavi Ayi Kossigan, Kouadio Laurent, Adabra Komlan, Tengue Kodjo, Tijami Fouad, Jalil Abdelouahed
Service de Chirurgie Oncologique, Institut National d'Oncologie, Rabat, Maroc.
Chirurgie Générale, Viscérale, Chirurgie Oncologique, Clinique Médico-chirurgicale, Centre Hospitalier Universitaire Sylvanus Olympio, Lomé, Togo.
Pan Afr Med J. 2016 Jun 15;24:145. doi: 10.11604/pamj.2016.24.145.8485. eCollection 2016.
To analyze our surgical management and the result of squamous cell carcinoma (SCC) of vulva. Retrospectively, we collected 38 cases of SCC; 17 cases of them were early SCC and 21 cases were locally advanced. The patients underwent primary surgery. The survival was estimated using Kaplan-Meier analysis and the log rank test. The mean age was 60.78 years. Total vulvectomy was performed in all patients. Superficial and deep incision of bilateral inguinal lymphadenectomy was performed by separates incisions for SCC infiltrating more than 1mm. The average tumor size was 53 mm (10 to 140mm). Morbidity was 42.1%. Lateral resection margin ≥8mm was obtained in 57.1%. Eighteen patients benefited from adjuvant radiotherapy. The follow-up median was 19.4 months (6 to 61.5 month) with 05 recurrences in 12 months. The survival using the Kaplan-Meyer analysis at 5 years, was 62.1% (71.2%N(-) vs 46.7%N(+); p = 0.13). We identified two groups for locally advanced vulva cancer. Primary surgery keeps its place. Neo adjuvant radio chemotherapy followed by surgery is the alternative treatment for locally extensive lesions.
分析我们对外阴鳞状细胞癌（SCC）的手术治疗及结果。我们回顾性收集了38例SCC患者；其中17例为早期SCC，21例为局部晚期。患者接受了一期手术。采用Kaplan-Meier分析和对数秩检验评估生存率。平均年龄为60.78岁。所有患者均行全外阴切除术。对于浸润超过1mm的SCC，通过单独切口进行双侧腹股沟淋巴结清扫的浅部和深部切口。平均肿瘤大小为53mm（10至140mm）。发病率为42.1%。57.1%的患者侧切缘≥8mm。18例患者接受了辅助放疗。随访中位时间为19.4个月（6至61.5个月），12个月内有5例复发。采用Kaplan-Meyer分析，5年生存率为62.1%（N（-）为71.2%，N（+）为46.7%；p = 0.13）。我们将局部晚期外阴癌分为两组。一期手术仍有其地位。新辅助放化疗后再手术是局部广泛病变的替代治疗方法。
