Sites of failure and times to failure in carcinoma of the vulva treated conservatively: A Gynecologic Oncology Group study☆,☆☆,★
Section snippets
Eligibility
Between 1983 and 1990, the GOG conducted two prospective trials evaluating the efficacy of conservative therapy for patients with carcinoma of the vulva.3, 4 One hundred forty-three patients in these studies received one or more modifications of traditional therapy. All patients had primary, previously untreated invasive squamous cell carcinoma of the vulva, clinical stages I to III (International Federation of Gynecology and Obstetrics, 1971). On clinical examination the vulvar lesion must
RESULTS
There were 143 patients entered in the two conservative study arms (120 in protocol No. 74 and 23 on protocol No. 88). Patient characteristics are shown in Table II. The median patient age was 61 years. The majority of patients (121, 84.6%) had clinical stage I disease and were considered candidates for conservative therapy.
There were 20 deaths (14.0%) caused by recurrent vulvar cancer. No deaths resulted from treatment or treatment-related complications; 17 patients died of intercurrent
COMMENT
For patients with stage I vulvar cancer, recurrence on the vulva is found in 6% to 11% of patients; recurrence in the groin is seen in 4% to 6% of patients.1, 2, 3, 15, 16 For patients with more advanced disease the risk of vulvar recurrence increased to as high as 17%.1, 2, 7 The risk of groin recurrence is low except for the subset of patients with metastatic disease in the inguinal nodes.8
Other authors have noted a trend for vulvar recurrence to develop earlier than groin recurrence. In a
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Cited by (0)
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From the Department of Obstetrics and Gynecology, Indiana University School of Medicinea; the Gynecologic Oncology Group and the Roswell Park Cancer Instituteb; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New England Medical Center and Tufts University School of Medicinec; and the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University School of Medicine.d
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