a Department of Obstetrics and Gynecology, Division of Gynecologic Oncology , Washington University School of Medicine, Alvin J. Siteman Cancer Center , St. Louis , MO , USA.
Expert Rev Anticancer Ther. 2019 Jan;19(1):43-50. doi: 10.1080/14737140.2019.1538797. Epub 2018 Oct 26.
Although a relatively uncommon disease, the treatment of vulvar cancer has changed considerably over the years and has been under considerable focus due to its past overtreatment and apparent increase in incidence. The purpose of this review is to describe the recommended management of the most commonly encountered vulvar carcinomas based on the most recent available literature. Areas covered: The clinical environment of squamous cell vulvar cancers are illustrated in order to describe the potential pitfalls and limitations of treatment. Then, by examining published data on the treatment efficacy, find those that are best at limiting morbidity and maximizing patient outcomes. In addition, effective prevention of HPV-related disease will be included as its limitation of disease can be considered an aspect of treatment. The benefits and limitations of medical and surgical modalities as well as the evolving discussion surrounding lymph node sampling and the novel role of genomics will also be considered. Expert commentary: Great care should be taken by the gynecologic oncology community regarding prevention and continuing efforts of limiting surgical morbidity while providing quality care. Although sentinel lymph node dissection is a controversial topic, greater attention should be paid to clinical trials to delineate the data, but also to limit our own biases in counseling patients.
尽管外阴癌是一种相对罕见的疾病,但多年来其治疗方法已经发生了很大的变化,由于过去的过度治疗和发病率的明显增加,它一直受到广泛关注。本综述的目的是根据最新的可用文献,描述最常见的外阴癌的推荐治疗方法。涵盖领域:为了描述治疗的潜在陷阱和局限性,阐述了鳞状细胞外阴癌的临床环境。然后,通过检查关于治疗效果的已发表数据,找到那些最能限制发病率和最大限度提高患者结局的治疗方法。此外,还将包括 HPV 相关疾病的有效预防,因为可以将疾病的局限性视为治疗的一个方面。还将考虑医学和手术方式的益处和局限性,以及围绕淋巴结取样和基因组学新作用的不断发展的讨论。专家评论:妇科肿瘤学界应特别注意预防,并继续努力限制手术发病率,同时提供高质量的护理。虽然前哨淋巴结活检术是一个有争议的话题,但应更加关注临床试验来阐述数据,但也要限制我们在为患者提供咨询时的偏见。