Kaban Alpaslan, Kaban Işık, Afşar Selim
University of Istanbul, Istanbul Faculty of Medicine, Gynecologic Oncology Department, Istanbul, Turkey.
Istanbul Education & Research Hospital, Istanbul, Turkey.
Gynecol Oncol Rep. 2017 Feb 10;20:41-46. doi: 10.1016/j.gore.2017.02.004. eCollection 2017 May.
Vulvar cancers, which constitute 5% of all gynecologic cancers, are the fourth most common female genital cancers, preceded by uterine, ovarian and cervical cancers. The treatment methods employed for vulvar cancers have changed over the years, with previously applied radical surgical approaches, such as en bloc resection, being gradually suspended in favor of treatment approaches that require dissection of less tissue. While the removal of less tissue, which today's approaches have focused on, prevents morbidity, this method seems to result in higher risks of recurrence. It is therefore important that the balance between preventing the recurrence of the disease and forefending against postoperative complications and vulvar deformity be properly understood. As a working assumption, if patients with vulvar cancer are diagnosed at an early stage, properly evaluated and administered appropriate treatment, the most positive results can be obtained. This paper aims to highlight this assumption and demonstrate, through the provision of actual data, how to plan the treatment approach for patients who are diagnosed early. Statements extracted from the National Comprehensive Cancer Network (NCCN) Guidelines Version 1.2016 Sub-Committees on vulvar squamous cell carcinoma and articles by the European Society of Gynaecological Oncology (ESGO) regarding Vulvar Cancer Recommendations were used to obtain updated information.
外阴癌占所有妇科癌症的5%,是第四大常见的女性生殖系统癌症,排在子宫癌、卵巢癌和宫颈癌之后。多年来,外阴癌的治疗方法发生了变化,以前采用的根治性手术方法,如整块切除,逐渐被摒弃,转而采用需要切除更少组织的治疗方法。虽然如今的治疗方法侧重于切除更少的组织,这可以预防并发症,但这种方法似乎会导致更高的复发风险。因此,正确理解预防疾病复发与预防术后并发症和外阴畸形之间的平衡非常重要。作为一个可行的假设,如果外阴癌患者在早期被诊断出来,经过适当评估并接受适当治疗,就能获得最理想的结果。本文旨在强调这一假设,并通过提供实际数据,展示如何为早期诊断的患者规划治疗方案。从《美国国立综合癌症网络(NCCN)指南》2016年第1版外阴鳞状细胞癌小组委员会以及欧洲妇科肿瘤学会(ESGO)关于外阴癌建议的文章中提取的陈述,用于获取最新信息。