Miller B, Morris M, Levenback C, Burke T W, Gershenson D M
Department of Gynecologic Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Gynecol Oncol. 1995 Aug;58(2):202-5. doi: 10.1006/gyno.1995.1211.
Twenty-one patients who underwent pelvic exenteration for primary (n = 8) or recurrent (n = 13) vulvar malignancy at the M. D. Anderson Cancer Center between 1956 and 1989 were evaluated. A posterior exenteration was performed in 12 patients, anterior exenteration was performed in 6, and total exenteration was performed in 3. In patients with primary tumors, radical vulvectomy and inguinal lymphadenectomy were also performed. The median patient age was 57 years. The mean tumor diameters were 5 cm (primary) and 4 cm (recurrent). Infections were the most frequent postoperative complications (n = 15), followed by pulmonary (n = 4) and cardiac problems (n = 3). There were no treatment-related deaths. Five patients required further surgery to correct late postoperative sequelae. Four of eight patients experienced recurrence after treatment of their primary tumor; the recurrences were local only (n = 1), in the inguinal area (n = 2), or local and in the pelvis (n = 1). Nine of the 13 patients treated for recurrent tumors developed a second recurrence; the second recurrences were all within the pelvis, although two also had a distant component. The 5-year survival rates were 70% for patients treated for primary disease and 38% for patients treated for recurrent disease. Pelvic exenteration is indicated for selected patients with advanced vulvar malignancy.
对1956年至1989年间在MD安德森癌症中心因原发性（n = 8）或复发性（n = 13）外阴恶性肿瘤接受盆腔脏器清除术的21例患者进行了评估。12例患者接受了后盆腔脏器清除术，6例接受了前盆腔脏器清除术，3例接受了全盆腔脏器清除术。对于原发性肿瘤患者，还进行了根治性外阴切除术和腹股沟淋巴结清扫术。患者的中位年龄为57岁。原发性肿瘤的平均直径为5 cm，复发性肿瘤为4 cm。感染是最常见的术后并发症（n = 15），其次是肺部并发症（n = 4）和心脏问题（n = 3）。没有与治疗相关的死亡病例。5例患者需要进一步手术纠正术后晚期后遗症。8例原发性肿瘤患者中有4例在治疗后复发；复发仅为局部复发（n = 1）、腹股沟区复发（n = 2）或局部及盆腔复发（n = 1）。13例复发性肿瘤患者中有9例出现二次复发；二次复发均在盆腔内，尽管其中2例也有远处转移。原发性疾病患者的5年生存率为70%，复发性疾病患者为38%。盆腔脏器清除术适用于部分晚期外阴恶性肿瘤患者。
