tailieunhanh - Management of Squamous Cell Cancer of the Vulva

Less common uterine cancers that do not come from glandular tissue of the endometrium are called uterine sarcomas. These types of cancer are not covered here because their treatment and outlook for survival are different from the most common cancers of the endometrium. If you would like to know more about this type of cancer please see our document called Uterine Sarcoma. Cervical cancers Cancers that start in the cervix and then spread to the body of the uterus are different from cancers that start in the body of the uterus. They are described in our document, Cervical Cancer | SOGC CLINICAL PRACTICE GUIDELINES No. 180 July 2006 Management of Squamous Cell Cancer of the Vulva This guideline has been reviewed by the SOGC GOC SCC Policy and Practice Guidelines Committee and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. This document replaces the document number 2 dated 1993. PRINCIPAL AUTHOR Wylam Faught MD FRCSC Edmonton AB SOGC GOC SCC POLICY AND PRACTICE GUIDELINES COMMITTEE MEMBERS John Jeffrey Chair MD FRCSC Kingston ON Peter Bryson MD FRCSC Kingston ON Lesa Dawson MD FRCSC St. John s NL Wylam Faught MD FRCSC Edmonton AB Michael Helewa MD FRCSC Winnipeg MB Janice Kwon MD FRCSC London ON Susie Lau MD FRCSC Montreal QC Robert Lotocki MD FRCSC Winnipeg MB Diane Provencher MD FRCSC Montreal QC Abstract Objectives To review and make recommendations regarding the management of early and advanced squamous cell cancer of the vulva. Options Radical vulvectomy and groin dissection or more conservative surgery in early squamous cell vulvar cancer chemotherapy and radiation followed by consideration of surgery in advanced disease. Outcomes Risk of inguinal lymph node metastases risk of tumour recurrence patient morbidity patient survival. Evidence Follows the quality of evidence assessment of the Canadian Task Force on the Periodic Health Examination Table 1 . Key Words Vulvar cancer inguinal lymph nodes vulvectomy radiation chemotherapy Recommendations 1. Stage IA lesions 2 cm diameter and 1 mm stromal invasion can be managed by radical local tumour excision without inguinofemoral node dissection. II-2B 2. Stage IB unilateral lesion 2 cm diameter 1 mm stromal invasion and 1 cm from the midline is treated by radical wide local excision completed by an ipsilateral inguinofemoral node dissection a central lesion within 1 cm from the midline requires bilateral inguinofemoral node dissection. II-2B 3. Patients with either three or more micrometastases in the groin with node size 10 mm with .

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