Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Debate 48A Should the Subsequent Management of Patients with Vulvar Cancer and a Positive Sentinel Lymph Node be Complete Groin Lymph Node Dissection or Radiation Therapy?
- Debate 48B Should the Subsequent Management of Patients with Vulvar Cancer and a Positive Sentinel Lymph Node be Complete Groin Lymph Node Dissection or Radiation Therapy?
- Debate 49A What is the Best Treatment for Stage I Vulvar Squamous Cell Carcinoma with either a Close or Positive Surgical Margin?
- Debate 49B What is the Best Treatment for Stage I Vulvar Squamous Cell Carcinoma with either a Close or Positive Surgical Margin?
- Debate 50A Should Adjuvant Radiation be Given to Women with Single Node Positive Vulvar Cancer?
- Debate 50B Should Adjuvant Radiation Therapy be Given to Patients with Single Node Positive Vulvar Cancer?
- Debate 51A Is Pelvic Exenteration an Option for a Pelvic Recurrence of a Vulvar/Vaginal Melanoma after Previous Radiation Therapy?
- Debate 51B Is Pelvic Exenteration an Option for a Pelvic Recurrence of a Vulvar/Vaginal Melanoma after Previous Radiation Therapy?
- Index
- References
Debate 49A - What is the Best Treatment for Stage I Vulvar Squamous Cell Carcinoma with either a Close or Positive Surgical Margin?
Re-excision
from Section VI - Vaginal and Vulvar Cancer
Published online by Cambridge University Press: 20 July 2023
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Debate 48A Should the Subsequent Management of Patients with Vulvar Cancer and a Positive Sentinel Lymph Node be Complete Groin Lymph Node Dissection or Radiation Therapy?
- Debate 48B Should the Subsequent Management of Patients with Vulvar Cancer and a Positive Sentinel Lymph Node be Complete Groin Lymph Node Dissection or Radiation Therapy?
- Debate 49A What is the Best Treatment for Stage I Vulvar Squamous Cell Carcinoma with either a Close or Positive Surgical Margin?
- Debate 49B What is the Best Treatment for Stage I Vulvar Squamous Cell Carcinoma with either a Close or Positive Surgical Margin?
- Debate 50A Should Adjuvant Radiation be Given to Women with Single Node Positive Vulvar Cancer?
- Debate 50B Should Adjuvant Radiation Therapy be Given to Patients with Single Node Positive Vulvar Cancer?
- Debate 51A Is Pelvic Exenteration an Option for a Pelvic Recurrence of a Vulvar/Vaginal Melanoma after Previous Radiation Therapy?
- Debate 51B Is Pelvic Exenteration an Option for a Pelvic Recurrence of a Vulvar/Vaginal Melanoma after Previous Radiation Therapy?
- Index
- References
Summary
Re-excision is the best treatment for stage I vulvar squamous cell carcinoma with close or positive surgical margins. Given the relative rarity of stage I vulvar cancer, to date there are no prospective studies that directly evaluate re-excision versus adjuvant radiation for close or positive margins. More recent retrospective studies question if margin status truly predicts recurrence and if any further treatment following primary excision is warranted. Vulvar surveillance is simple with direct visualization, and re-excision is effective for most recurrences. Adjuvant radiation has a host of morbid and often permanent side effects with nearly all patients experiencing some degree of these complications. Further, adjuvant radiation complicates treatment of future recurrences by hampering future healing and eliminating radiation as a future treatment option. Thus, although adjuvant vulvar radiation may have the potential to reduce local recurrence, the associated long-term morbidity risk far outweighs the benefits, and re-excision in the treatment of choice for patients with stage I vulvar squamous cell carcinoma with close or positive surgical margins.
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- Chapter
- Information
- 50 Big Debates in Gynecologic Oncology , pp. 297 - 299Publisher: Cambridge University PressPrint publication year: 2023