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Abstract

Vulvar Cancer Treatm

The modern treatment of vulvar cancer is less radical, stage-dependent and based on many individual treatment concepts. In early stage of vulvar cancers is the locally surgical tumor removal the treatment of choice. In the advanced cases, a radical removal of the vulva according to triple incision technique should be carried out.

Vulvar cancer with an infiltration depth of 1 cm or less can be treated without inguinal lymph node dissection. In the absence of clinic suspicious inguinal lymph nodes, tumor diameter of less than 4 cm and unifocal carcinoma sentinel lymph node biopsy is a promising technique, but it is still not yet fully established as a standard therapy. The pelvic lymphadenectomy with positive inguinal lymph nodes is controversial. The criteria for adjuvant radiotherapy of the vulva are still unclear. In general, irradiation of the vulva is recommended only when the primary tumor could not be removed completely. Indications for adjuvant inguinal radiotherapy may be: when two or more nodes are involved or if a single node has extracapsular spread or a macrometastasis of more than 10 mm.

advanced stages of vulvar cancers the neoadjuvante chemoradiation treatment concept is the first choice. CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(2): 178–187

Keywords
Vulvar cancer treatment, triple incision technique, inguinal lymph node dissection, sentinel lymph node biopsy, chemoradiation

Mustafa Zelal Muallem, Jalid Sehouli
Klinik für Gynäkologie, Charité – Universitätsmedizin Berlin, Berlin
Reviewer: Oumar Camara, Bad Langensalza,
Fabian Trillsch, Hamburg, Uwe Wagner, Marburg,
und Jörg Schwarz, Reinbek

Muallem MZ. Therapie ... Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(2): 178–187 publiziert 31.7.2013 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2013 ISSN 1614-8533