Department of Gynecological Oncology, 68196Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Medical Faculty Ljubljana, 37663University of Ljubljana, Ljubljana, Slovenia.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221116489. doi: 10.1177/15330338221116489.
: Pelvic exenteration in women with recurrent vulvar carcinoma is associated with high morbidity and mortality and substantial treatment costs. Because pelvic exenteration severely affects the quality of life and can lead to significant complications, other treatment modalities, such as electrochemotherapy, have been proposed. The aim of this study was to evaluate the feasibility and suitability of electrochemotherapy in the treatment of recurrent vulvar cancer. We aimed to analyze the treatment options, treatment outcomes, and complications in patients with recurrent vulvar cancer of the perineum. A retrospective analysis of patients who had undergone pelvic exenteration for vulvar cancer at the Institute of Oncology Ljubljana over a 16-year period was performed. As an experimental, less mutilating treatment, electrochemotherapy was performed on one patient with recurrent vulvar cancer involving the perineum. Comparative data analysis was performed between the group with pelvic exenteration and the patient with electrochemotherapy, comparing hospital stay, disease recurrence after treatment, survival after treatment in months, and quality of life after treatment. We observed recurrence of disease in 2 patients with initial FIGO stage IIIC disease 3 months and 32 months after pelvic exenteration, and they died of the disease 15 and 38 months after pelvic exenteration. Two patients with FIGO stage IB were alive at 74 and 88 months after pelvic exenteration. One patient with initial FIGO stage IIIC was alive 12 months after treatment with electrochemotherapy with no visible signs of disease progression in the vulvar region, and the lesions had a complete response. The patient treated with electrochemotherapy was hospitalized for 4 days compared with the patients with pelvic exenteration, in whom the average hospital stay was 19.75 (± 1.68) days. Our experience has shown that electrochemotherapy might be a less radical alternative to pelvic exenteration, especially for patients with initially higher FIGO stages.
: 女性复发性外阴癌行盆腔廓清术与高发病率、死亡率和大量治疗费用相关，且严重影响生活质量，并可能导致严重并发症。因此，除了盆腔廓清术，其他治疗方法如电化学疗法也已被提出。本研究旨在评估电化学疗法治疗复发性外阴癌的可行性和适用性。我们旨在分析会阴复发性外阴癌患者的治疗选择、治疗效果和并发症。
对在卢布尔雅那肿瘤研究所行盆腔廓清术治疗外阴癌的患者进行了 16 年的回顾性分析。对一名患有累及会阴的复发性外阴癌患者进行了电化学疗法的实验性、非致残性治疗。比较了行盆腔廓清术的患者组与行电化学疗法的患者组之间的住院时间、治疗后疾病复发情况、治疗后生存月数和治疗后生活质量。
我们观察到 2 名初始FIGO 分期为 III C 期的患者在盆腔廓清术后 3 个月和 32 个月时疾病复发，且分别在盆腔廓清术后 15 个月和 38 个月死于该疾病。2 名FIGO 分期为 IB 期的患者在盆腔廓清术后 74 个月和 88 个月时仍然存活。1 名初始FIGO 分期为 III C 期的患者在接受电化学疗法治疗后 12 个月时仍然存活，外阴区域未见疾病进展迹象，病变完全缓解。接受电化学疗法治疗的患者住院 4 天，而行盆腔廓清术的患者平均住院时间为 19.75（±1.68）天。
我们的经验表明，电化学疗法可能是一种比盆腔廓清术更具侵袭性的替代方案，特别是对于初始FIGO 分期较高的患者。
