Cancer vulvar

Koh W-J, Wallace J, Greer BE, et al. Combined radiotherapy and chemotherapy in the management of local-regionally advanced vulvar cancer. Int J Radial Oncol Biol Phys 1993 26 809-816. 

A number of phase I and II trials of chemoradiation for gynecologic malignancies have included patients with vaginal or vulvar cancer, but the number of patients with these rare malignancies has been too small to support large randomized trials. 

In general, phase II trials of chemoradiation for vulvar cancer have yielded encouraging response rates (Table 4). Most studies of cisplatin or mitomycin C plus fluorouracil have yielded vulvar local control rates of better than 50% in women with advanced... 

Moore DH, Thomas GM, Montana GS, et al. Preoperative chemoradiation for advanced vulvar cancer a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys 1998 42 79-85. 

Leiserowitz GS, Russell AH, Kinney WK, et al. Prophylactic chemoradiation of inguinofemoral lymph nodes in patients with locally extensive vulvar cancer. Gynecol Oncol 1997 66 509-514. 

BOX 13.1 Hemivulvectomy for vulvar cancer the wrong side removed... 

Fig. 15.7a,b. Abnormally enlarged metastatic inguinal lymph node on the left [arrow). Axial images obtained with (a) T2w TSE sequence and (b) Tlw TSE sequence in a patient with vulvar cancer... 

In the United States, vulvar cancer accounts for 4% of cancers in the female reproductive organs and 0.6% of all cancers in women. The American Cancer Society estimated that in the year 2001, about 3,600 cancers of the vulva would be diagnosed in the US. and about 800 deaths due to vulvar cancers were expected during 2001. 

Over 90% of the cancers of the vulva are squamous cell cancers. This type of cancer usually forms slowly over many years and is usually preceded by precan-cerous changes that may last for several years. When vulvar cancer is detected early, it is highly curable. The overall 5-year survival rate when the lymph nodes are not involved is 90%, which declines to 20%-55% when the cancer has metastasized to the lymph nodes. The... 

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