Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy

A prospective study of the gynecologic oncology group

Frederick Stehman, Brian N. Bundy, Philip M. Dvoretsky, William T. Creasman

Research output: Contribution to journalArticle

256 Citations (Scopus)

Abstract

Although cure rates are high, the morbidity of radical operation for carcinoma of the vulva is substantial. Between 1983–1989, member institutions of the Gynecologic Oncology Group entered 155 patients in a prospective evaluation of modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy for clinical stage I vulvar cancer. Only patients with neoplastic thickness of 5 mm or less, without vascular space invasion, and negative inguinal lymph nodes were eligible for this study. There have been 19 recurrences and seven deaths from disease among the 121 eligible and evaluable patients. Patients whose disease recurred on the vulva were frequently (eight of ten patients) salvaged by further operation. Five of the seven deaths due to cancer occurred among patients whose first recurrence was in the groin. Acute and long-term morbidity as well as hospital stay were each less than in the Group's previous experience in a comparable patient population treated with radical vulvectomy and bilateral inguinal-femoral lymphadenectomy. There was a significantly increased risk of recurrence but not death when compared with these same historic controls. Modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy is an alternative to traditional radical operation for these selected patients with stage I carcinoma of the vulva. The number of patients who experienced recurrence in the operated groin is of concern and may be attributable to the decision to leave the femoral nodes intact.

Original languageEnglish
Pages (from-to)490-497
Number of pages8
JournalObstetrics and Gynecology
Volume79
Issue number4
StatePublished - 1992

Fingerprint

Vulva
Groin
Lymph Node Excision
Prospective Studies
Carcinoma
Recurrence
Thigh
Vulvar Neoplasms
Morbidity
Blood Vessels
Length of Stay
Lymph Nodes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy : A prospective study of the gynecologic oncology group. / Stehman, Frederick; Bundy, Brian N.; Dvoretsky, Philip M.; Creasman, William T.

In: Obstetrics and Gynecology, Vol. 79, No. 4, 1992, p. 490-497.

Research output: Contribution to journalArticle

@article{9a30f70a87b64aae9dab61f23bef8724,
title = "Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy: A prospective study of the gynecologic oncology group",
abstract = "Although cure rates are high, the morbidity of radical operation for carcinoma of the vulva is substantial. Between 1983–1989, member institutions of the Gynecologic Oncology Group entered 155 patients in a prospective evaluation of modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy for clinical stage I vulvar cancer. Only patients with neoplastic thickness of 5 mm or less, without vascular space invasion, and negative inguinal lymph nodes were eligible for this study. There have been 19 recurrences and seven deaths from disease among the 121 eligible and evaluable patients. Patients whose disease recurred on the vulva were frequently (eight of ten patients) salvaged by further operation. Five of the seven deaths due to cancer occurred among patients whose first recurrence was in the groin. Acute and long-term morbidity as well as hospital stay were each less than in the Group's previous experience in a comparable patient population treated with radical vulvectomy and bilateral inguinal-femoral lymphadenectomy. There was a significantly increased risk of recurrence but not death when compared with these same historic controls. Modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy is an alternative to traditional radical operation for these selected patients with stage I carcinoma of the vulva. The number of patients who experienced recurrence in the operated groin is of concern and may be attributable to the decision to leave the femoral nodes intact.",
author = "Frederick Stehman and Bundy, {Brian N.} and Dvoretsky, {Philip M.} and Creasman, {William T.}",
year = "1992",
language = "English",
volume = "79",
pages = "490--497",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Early stage I carcinoma of the vulva treated with ipsilateral superficial inguinal lymphadenectomy and modified radical hemivulvectomy

T2 - A prospective study of the gynecologic oncology group

AU - Stehman, Frederick

AU - Bundy, Brian N.

AU - Dvoretsky, Philip M.

AU - Creasman, William T.

PY - 1992

Y1 - 1992

N2 - Although cure rates are high, the morbidity of radical operation for carcinoma of the vulva is substantial. Between 1983–1989, member institutions of the Gynecologic Oncology Group entered 155 patients in a prospective evaluation of modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy for clinical stage I vulvar cancer. Only patients with neoplastic thickness of 5 mm or less, without vascular space invasion, and negative inguinal lymph nodes were eligible for this study. There have been 19 recurrences and seven deaths from disease among the 121 eligible and evaluable patients. Patients whose disease recurred on the vulva were frequently (eight of ten patients) salvaged by further operation. Five of the seven deaths due to cancer occurred among patients whose first recurrence was in the groin. Acute and long-term morbidity as well as hospital stay were each less than in the Group's previous experience in a comparable patient population treated with radical vulvectomy and bilateral inguinal-femoral lymphadenectomy. There was a significantly increased risk of recurrence but not death when compared with these same historic controls. Modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy is an alternative to traditional radical operation for these selected patients with stage I carcinoma of the vulva. The number of patients who experienced recurrence in the operated groin is of concern and may be attributable to the decision to leave the femoral nodes intact.

AB - Although cure rates are high, the morbidity of radical operation for carcinoma of the vulva is substantial. Between 1983–1989, member institutions of the Gynecologic Oncology Group entered 155 patients in a prospective evaluation of modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy for clinical stage I vulvar cancer. Only patients with neoplastic thickness of 5 mm or less, without vascular space invasion, and negative inguinal lymph nodes were eligible for this study. There have been 19 recurrences and seven deaths from disease among the 121 eligible and evaluable patients. Patients whose disease recurred on the vulva were frequently (eight of ten patients) salvaged by further operation. Five of the seven deaths due to cancer occurred among patients whose first recurrence was in the groin. Acute and long-term morbidity as well as hospital stay were each less than in the Group's previous experience in a comparable patient population treated with radical vulvectomy and bilateral inguinal-femoral lymphadenectomy. There was a significantly increased risk of recurrence but not death when compared with these same historic controls. Modified radical hemivulvectomy and ipsilateral inguinal lymphadenectomy is an alternative to traditional radical operation for these selected patients with stage I carcinoma of the vulva. The number of patients who experienced recurrence in the operated groin is of concern and may be attributable to the decision to leave the femoral nodes intact.

UR - http://www.scopus.com/inward/record.url?scp=0026548823&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026548823&partnerID=8YFLogxK

M3 - Article

VL - 79

SP - 490

EP - 497

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 4

ER -