RESUMO
The clinical staging of malignant disease is necessary before initiating nonsurgical therapy. Unfortunately, such staging does not help answer critical questions about the course and natural history of the cancerous process. Answers to these questions are crucial to the planning of future therapeutic programs. A postoperative staging system, amenable to computer analysis, that can be retrospectively applied to a large series of invasive squamous cell carcinomas of the vulva is presented. A review of the experience of a large oncologic service at the University of Buenos Aires, which used this new classification system, shows the system's applicability. Such a system could, in time, provide answers to many questions concerning invasive squamous cell carcinoma of the vulva.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Vulvares/patologia , Argentina , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Tempo , Neoplasias Vulvares/mortalidade , Neoplasias Vulvares/cirurgiaRESUMO
Retrospective analysis of 22 cases of Stage I invasive carcinoma of the vulva showed 11 cases in which the depth of tumor invasion was 5 mm or less. All of these patients were treated with radical vulvectomy and lymphadenectomy. In 3 cases positive groin node metastases were discovered. A fourth patient with minimal stromal invasion (less than 5 mm) was prospectively managed with vulvectomy alone and subsequently developed groin node metastasis leading to death from disseminated tumor. Depth of the invasion alone, therefore, is not a reliable indicator of the likelihood of groin node involvement, and lymphadenectomy should continue to be considered for all patients with invasive squamous cell carcinoma of the vulva.
