Wolcott H D, Gallup D G
Am J Obstet Gynecol. 1984 Nov 15;150(6):695-8. doi: 10.1016/0002-9378(84)90669-0.
A retrospective study of 56 patients treated for carcinoma in situ of the vulva over a 24-year period has shown a relative increase in the occurrence of this neoplasm. Only 6.7% of patients in the first 14 years of the study period were less than 35 years of age, as compared with 29.3% in the last decade. In the earlier years of the study, simple vulvectomy was the primary treatment, and 81.3% of the patients were disease-free at 5 years. Wide local excision, used in the later years, resulted in a rate of 46.2% with no evidence of disease. Involvement of surgical margins played a significant role in this increased incidence of recurrence. Only one patient, originally treated by simple vulvectomy, later developed early stromal invasion. A wide local excision technique should be strongly considered as initial management of this multifocal neoplasm. Close follow-up is mandatory. Recurrence of disease may be treated with appropriate wide excision.
一项对56例在24年期间接受外阴原位癌治疗的患者的回顾性研究显示，这种肿瘤的发生率相对有所增加。在研究期的前14年中，只有6.7%的患者年龄小于35岁，而在过去十年中这一比例为29.3%。在研究的早期，单纯外阴切除术是主要的治疗方法，81.3%的患者在5年后无疾病。后期采用的广泛局部切除术，无疾病证据的比例为46.2%。手术切缘受累在这种复发率增加中起了重要作用。只有一名最初接受单纯外阴切除术治疗的患者后来发生了早期间质浸润。对于这种多灶性肿瘤，应强烈考虑将广泛局部切除技术作为初始治疗方法。密切随访是必需的。疾病复发可用适当的广泛切除术治疗。
