Tham K F, Shepherd J H, Lowe D G, Hudson C N, Van Dam P A
Gynaecological Oncology Unit, St Bartholomew's Hospital, London, UK.
Eur J Surg Oncol. 1993 Aug;19(4):361-7.
There is a trend towards conservative surgery for early vulval cancer, which is increasingly being diagnosed in younger women. In this series there were 21 patients who had lesions which had invaded to a depth of 3 mm or less. Nine patients were treated by wide local excision without any form of lymphadenectomy, and eight patients had wide local excision with ipsilateral groin dissection. In the remaining four patients, radical surgery was carried out, consisting of radical vulvectomy and bilateral lymphadenectomy. None of the 12 patients who had some form of lymphadenectomy was shown to have nodal involvement. None of the patients suffered from local recurrence or recurrence in the groin nodes. No patient died from vulval cancer, and all but one of the patients are still alive with a mean follow-up period of 54.8 months. Though there is as yet no universal agreement on the criteria for early vulval cancer, with superficial invasion there is a place for individualized treatment, when patients will benefit from less than radical surgery.
对于早期外阴癌，目前存在采用保守手术的趋势，且早期外阴癌在年轻女性中的诊断越来越多。在本系列研究中，有21例患者的病变浸润深度为3毫米或更浅。9例患者接受了局部广泛切除，未进行任何形式的淋巴结清扫术；8例患者接受了局部广泛切除并进行了同侧腹股沟淋巴结清扫术。其余4例患者接受了根治性手术，包括根治性外阴切除术和双侧淋巴结清扫术。在接受某种形式淋巴结清扫术的12例患者中，均未发现有淋巴结受累。所有患者均未出现局部复发或腹股沟淋巴结复发。没有患者死于外阴癌，除1例患者外，所有患者均存活，平均随访期为54.8个月。尽管目前对于早期外阴癌的标准尚未达成普遍共识，但对于浅表浸润的情况，当患者能从小于根治性的手术中获益时，个体化治疗是可行的。
