Department of Obstetrics and Gynecology, the First Affiliated Hospital of Dalian Medical university, Dalian, 116011, People's Republic of China.
Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People's Republic of China.
Int J Med Sci. 2020 Sep 16;17(16):2578-2584. doi: 10.7150/ijms.49804. eCollection 2020.
In 2012, we proposed and described a modified triple incision technique (MTIT) for vulvar cancer patients with locally advanced disease. The MTIT has undergone a series of modifications, and a modified MTIT (M-MTIT) has been developed. The purpose of this study was to introduce the M-MTIT and compare it with the MTIT. This was a retrospective cohort study. Fifty-seven vulvar cancer patients with clinical stage T2 (≥ 4 cm) or T3 disease were included. Of these patients, 28 underwent the MTIT and 29 underwent the M-MTIT. Data on surgery-related complications and survival outcomes were compared. Patients who were treated with the M-MTIT developed significantly less surgery-related morbidities than patients treated with the MTIT (24.1% vs. 60.7%, = 0.005). Wound breakdown was the most common complication in our cohort, which occurred less frequently in the M-MTIT group than in the MTIT group (10.3% vs. 35.7%, = 0.022). Multivariate logistic regression analysis identified the M-MTIT as an independent predictor of a reduced risk of wound breakdown. The incidence of other complications, including lymphedema, wound infection and cellulitis, was lower in the M-MTIT group than in the MTIT group; however, the differences did not reach statistical significance. The median follow-up time of this study was 33 months. Kaplan-Meier survival graphs did not show significant differences in recurrence-free survival or overall survival between the two groups. The M-MTIT correlates with lower morbidity rates than the MTIT and does not compromise oncological safety. The M-MTIT can be considered a safe and feasible option for vulvar cancer patients with locally advanced disease.
2012 年，我们提出并描述了一种改良的三切口技术（MTIT），用于局部晚期外阴癌患者。MTIT 经历了一系列的修改，开发了一种改良的 MTIT（M-MTIT）。本研究的目的是介绍 M-MTIT 并将其与 MTIT 进行比较。这是一项回顾性队列研究。纳入了 57 例临床分期为 T2（≥4cm）或 T3 疾病的外阴癌患者。其中 28 例患者采用 MTIT，29 例患者采用 M-MTIT。比较了手术相关并发症和生存结果的数据。采用 M-MTIT 治疗的患者发生手术相关并发症的风险明显低于采用 MTIT 治疗的患者（24.1% vs. 60.7%，=0.005）。在我们的队列中，伤口破裂是最常见的并发症，在 M-MTIT 组比 MTIT 组发生率更低（10.3% vs. 35.7%，=0.022）。多变量逻辑回归分析确定 M-MTIT 是减少伤口破裂风险的独立预测因素。M-MTIT 组其他并发症（包括淋巴水肿、伤口感染和蜂窝织炎）的发生率低于 MTIT 组，但差异无统计学意义。本研究的中位随访时间为 33 个月。Kaplan-Meier 生存曲线显示两组患者无复发生存率或总生存率无显著差异。M-MTIT 与 MTIT 相比，发病率较低，且不影响肿瘤安全性。M-MTIT 可被认为是局部晚期外阴癌患者的一种安全可行的选择。
