Artículos de revistas
Clinically Undetectable Lymph Node Invasion In Vulvar Cancer [invasão Linfática Clinicamente Não Detectável Do Câncer Vulvar]
Registro en:
Revista Da Associacao Medica Brasileira. , v. 51, n. 4, p. 228 - 232, 2005.
1044230
10.1590/S0104-42302005000400020
2-s2.0-33645746122
Autor
Sarian L.O.Z.
Marshall P.S.
Derchain S.F.M.
Torres J.C.C.
Santos A.D.C.P.
De Souza G.A.
Institución
Resumen
OBJECTIVE. To assess the neoplastic invasion of superficial and deep inguinal lymph nodes of women with invasive vulvar squamous carcinoma smaller than 5 centimeters with a clinically normal inguinal region. Methods: the medical records of 59 women cared at the State University of Campinas with invasive vulvar squamous carcinoma T1 and T2 and who presented clinically normal inguinal regions (N0) were reviewed. Clinical characteristics of both tumor and patients were evaluated as well as the follow-up data. Odds ratios and Fisher's Exact Test were used to assess the correlations between the invasion of inguinal lymph nodes and tumor size, grade, relapses and clinical complications. Confidence limits of 95% were used. RESULTS. Age of the patients ranged from 34 to 91 years (mean 67 years), and follow-up time ranged from 3 days (peri-operatory death) to 252 months (mean 27 months). Clinically, 22 (37%) women had lesions T1 lesions and 37 (63%) T2. Histological analysis showed unilateral lymphatic invasion in six (10%) women and bilateral in three (5%). There was no significant association between tumor size and lymph node invasion. Also, pathologic tumor size and grade were not associated with lymph node neoplastic involvement. Relapses and late complications were not correlated with lymph node neoplastic invasion. CONCLUSIONS. Superficial and deep inguinal dissection disclosed clinically undetectable lymph node neoplastic invasion, although tumor size and histological grade, relapses and late complications were not associated with node involvement. 51 4 228 232 Coleman, R.L., Santoso, J.T., Vulvar carcinoma (2000) Curr Treat Opion Oncol, 1, pp. 177-190 Verdiani, L.A., Juliato, C.R., Derchain, S.F.M., Carcinoma da vulva: Epidemiologia e aspectos clínicos (1997) Rev Centro de Referência, 2, pp. 86-90 Canavan, T.P., Cohen, D., Vulvar cancer (2002) Am Fam Physician, 66, pp. 1269-1274 Disaia, P.J., Creasman, W.T., Invasive cancer of the vulva (1989) Clinical Gynecologic Oncology. 3 rd Ed., pp. 241-272. , Disaia PJ, Creasman WT. St Louis: Mosby De Hullu, J.A., Hollema, H., Lolkema, S., Boezen, M., Boonstra, H., Burger, M.O., Vulvarcarcinoma: The price of less radical surgery (2002) Cancer, 95, pp. 2331-2338 Micheletti, L., Levi, A.C., Bogliatto, F., Preti, M., Massobrio, M., Rationale and definition of the lateral extension of the inguinal lymphadenectomy for vulvar cancer derived from an embriological and anatomical study (2002) J Surg Oncol, 81, pp. 19-24 Kim, R.Y., Alvarez, R.D., Omura, G.A., Advances in the treatment of gynecologic malignancies. Part 1: Cancers of the cervix and vulva (2002) Oncology, 16, pp. 1510-1517 Rouzier, R., Haddad, B., Plantier, F., Dubois, P., Pelisse, M., Paniel, B.J., Local relapse in patients treated for squamous cell vulvar carcinoma: Incidence and prognostic value (2002) Obstet Gynecol, 100, pp. 1159-1167 Edwards, S., Handfield-Jones, S., Gull, S., National guidelines on the management of vulval conditions (2002) Int J STD AIDS, 13, pp. 411-415 Ulitin, H.C., Pak, Y., Dede, M., Can radiotherapy be a treatment option for elderly women with invasive vulvar carcinoma without radical surgery? (2002) Eur J Gynaecol Oncol, 23, pp. 426-428 Puig-Tintore, L.M., Ordi, J., Vidal-Sicart, S., Lejarcegui, J.Á., Torn, A., Pahisa, J., Further data on the usefulness of sentinel lymph node identification and ultrastaging in vulvar squamous cell carcinoma (2003) Gynecol Oncol, 88, pp. 29-34 Scheiströen, M., Nesland, J.M., Trope, C., Have patients with early squamous carcinoma of the vulva been overtreated in the past? The norvegian experience 1977-1991 (2002) Eur J Gynaecol Oncol, 23, pp. 93-103 Hullu, J.A., Van Der Zee, A.G., Sentinel node techniques in cancer of the vulva (2003) Curr Womens Health Rep, 3, pp. 19-26 Shepherd, J.H., Cervical and vulvar cancer: Changes in FIGO definitions of staging (1996) Br J Obstet Gynecol, 103, pp. 405-406 Scully, R.E., Bonfligio, T.A., Kurman, R.J., Silverberg, S.G., Wilkins, E.J., Histological typing of female genital tract tumors (1994) Histological Classification of Tumors. 2th Ed., , World Health Organization. International. Berlin: Springer-Verlag Bosquet, J.G., Kinney, W.K., Russel, A.H., Gaffey, T.A., Magrina, J.F., Podratz, K.C., Risk of occult inguinofemoral lymph node metastasis from squamous carcinoma of the vulva (2003) Int J Radiat Oncol Biol Phys, 2, pp. 419-424 Gomes-Rueda, N., Vighi, S., Garcia, A., Cardinal, L., Belardi, M.G., Di Paola, G., Histologic predictive factors: Therapeutic impact in vulvar cancer (1994) J Reprod Med, 39, pp. 71-76 Crum, C.P., Carcinoma of the vulva: Epidemiology and pathogenesis (1992) Obstet Gynecol, 79, pp. 448-454 Kurman, R.J., Trimble, C.L., Shah, K.V., Human papilloma virus and the pathogenesis of vulvar carcinoma (1992) Curr Opin Obstet Gynecol, 4, pp. 582-585 Trimble, C.L., Hildenshein, A., Brinton, L.A., Shah, K.V., Kurman, R.J., Heterogenous etiology of squamous carcinoma of the vulva (1996) Obstet Gynecol, 87, pp. 59-64 AlGhamdi, A., Freedman, D., Miller, D., Poh, C., Rosin, M., Zhang, L., Vulvar squamous cell carcinoma in young women: A clinicopathologic study of 21 cases (2002) Gynecol Oncol, 84, pp. 94-101 Morris, J.M., A formula for selective lymphadenectomy: Its application to cancer of the vulva (1977) Obstet Gynecol, 50, pp. 152-158 Hacker, N.F., Management of regional lymph nodes and their prognostic influence in vulvar cancer (1983) Obstet Gynecol, 61, pp. 408-412 DiSaia, P.J., Creasman, W.T., Rich, W.M., An alternate approach to early cancer of the vulva (1979) Am J Obstet Gynecol, 133, pp. 825-832 Gordinier, M.E., Malpica, A., Burke, T.W., Bodurka, D.C., Wolf, J.K., Jhingran, A., Groin recurrence in patients with vulvar cancer with negative nodes on superficial inguinal lymphadenectomy (2003) Gynecol Oncol, 90, pp. 625-628 Tilmans, A.S., Sutton, G.P., Look, K.Y., Sethman, F.B., Ehrilich, C.E., Hornback, N.B., Recurrent squamous carcinoma of the vulva (1992) Am J Obstet Gynecol, 167, pp. 1383-1389 Levenback, C., Burke, T.W., Gershenson, D.M., Morris, M., Malpica, A., Ross, M.I., Intraoperative lymphatic mapping for vulvar cancer (1994) Obstet Gynecol, 84, pp. 163-167 Terada, K.Y., Shimizu, D.M., Wong, J.H., Sentinel node dissection and ultrastaginc in squamous cell cancer of the vulva (2000) Gynecol Oncol, 76, pp. 40-44