УДК 618.16-006.04-089
E.L. Dikareva1,2, D.Yu. Konovalov2, V.I. Kim2
1Orenburg Regional Clinical Oncology Center, Orenburg
2Orenburg State Medical University, Orenburg
Dikareva E.L. ― Head of the Gynecology Department of Orenburg Regional Oncology Center
11 Gagarin Ave., Orenburg, Russian Federation, 460021, tel. +7-922-543-39-25, e-mail: orenonco.dikareva @ rambler.ru
Abstract. Results of treatment of 245 patients of the Orenburg Regional Clinical Oncology Center (ORCOC) with cancer of the vulva I-IV stage of the disease with different histological structure using different methods of special treatment for the period from 1995 to 2015. The main and most effective method of treatment for these patients is surgical technique. The radicality of surgical intervention are largely determined outcomes cancer vulva. The analysis of results of surgical treatment of patients with cancer vulvar testing using standard methods of surgical intervention and with reconstructive plastic surgery (the method of closing the wound defect displaced skin-fascial flap on the leg, the proposed A.V. Zharov, Ural State Medical Academy of additional education). Shown a significant decrease in early and late complications of surgical treatment using reconstructive plastic surgeries, improve treatment results cancer (decrease local recurrence, increased 5-year survival rate, improve the quality of life of patients). In the gynecology department ORCOC proposed to use in fixing the displaced skin-fascial flap to the vaginal wall single continuous suture. This technique made it possible to adapt the maximum layers of loose-surface tissues together. This reduces the possibility of hypertrophic and keloid scars. Reduce the number of long-term postoperative complications ― dysuria, vaginal stenosis, improving the quality of life of patients.
Key words: malignant neoplasms of the vulva, reconstructive and plastic surgery.
REFERENCES
1. Zharov A.V., Vazhenin A.V. Optimizatsiya lecheniya bol'nykh rakom vul'vy [Optimization of treatment of patients with vulvar cancer]. Chelyabinsk, 2005. Pp. 8-110.
2. Zharov A.V. Surgical treatment of patients with cancer of the vulva. Prakticheskaya onkologiya, 2006, vol. 7, no. 4, pp. 205-215 (in Russ.).
3. Koyro M.A. Long-term results of treatment of cancer of the external genitalia in women. Voprosy onkologii, 1962, vol. 2, no. 4, pp. 42-49 (in Russ.).
4. Kuznetsov V.V., Mekhtiev V.N., Korzhevskaya E.V. et al. Vulvar cancer: prognostic factors, treatment. Sovremennaya onkologiya, 2000, vol. 2, no. 2, pp. 37-39 (in Russ.).
5. Merabishvili V.M., Bakhidze E.V., Laliantsi E.I. et al. Prevalence of gynecologic cancer and the survival of patients. Voprosy onkologii, 2014, vol. 60, no. 3, pp. 288-296 (in Russ.).
6. Nerodo G.A., Sidorenko Yu.S. Ekonomnye operatsii u bol'nykh s preinvazivnym i mikroinvazivnym rakom vul'vy [Economical operation in patients with preinvasive and microinvasive cancer of the vulva]. Skrining i novye podkhody k lecheniyu nachal'nogo ginekologicheskogo raka: Materialy Rossiyskogo simpoziuma, Novgorod. Saint Petersburg, 1994. P. 67.
7. Ognerubov N.A., Voronina L.A., Evdokimova N.I. Rol' operatsii Dyukena v kombinirovannom lechenii raka naruzhnykh polovykh organov u zhenshchin [The role of the Duquesne operation in the combined treatment of cancer of the external genital organs of women]. Voronezh: Voronezhskaya GMA, 1996. 7 p.
8. Urmancheeva A.F. Epidemiology of cancer of the vulva. Risk factors and prognosis. Prakticheskaya onkologiya, 2006, vol. 7, no. 4, pp. 189-190 (in Russ.).
9. Charkviani L.I., Chkuaseli G.T., Miminoshvili I.L. Kartsinoma vul'vy v ONTs MZ GSSR v 1970-1968 gg. [Carcinoma of the vulva in the JRC in the Ministry of Health of the GSPC 1970-1968]. Epidemiologiya, profilaktika i lechenie raka vul'vy: Materialy simpoziuma. Tbilisi, 1985. Pp. 43-46.
10. Alkatout I., Schubert M., Garbrecht N. et al. Vulvar cancer: epidemiology, clinical presentation, and management options. International Journal of Women’s Health, 2015, Mar 20, no. 7, pp. 305-13.
11. Bodelon C., Madeleine M.M., Voigt L.F., Weiss N.S. Is the incidence of invasive vulvar cancer increasing in the United States? Cancer Causes Control, 2009, Nov, 20 (9), pp. 1-10. DOI: 10.1007 [PMID 19680749].
12. Buchler D.A., Kline J.C., Tunca J.C., Carr W.F. Treatment of Recurrent Carcinoma of the Vulvae. Gynecol. Oncol., 1979, vol. 8, no. 2, pp. 180-184.
13. Buttmann-Schweiger N., Klug S.J., Luyten A. et al. Incidence patterns and temporal trends of invasive nonmelanotic vulvar tumors in Germany 1999-2011. A population-based cancer registry analysis. PLoS ONE. DOI: 10.1371.
14. Frederick B. Stehman invasive vulvar cancer. Klinicheskaya onkoginekologiya, vol. 1, 2001, pp. 229-230 (in Russ.).
15. Fioretti P., Gaducci A., Facchini V. et al. Analisi degli insuccessi della chirurgia radicale nel trattamento del carcinoma invasivo a cellule squamose della vulva. Minerva ginecol, 1988, vol. 40 (8), pp. 451-456.
16. Ghebre R.G., Posthuma R., Vogel R.I. et al. Effect of age and comorbidity on the treatment and survival of older patients with vulvar cancer. Gynecol. Oncol, 2011 Jun 1, 121 (3). pp. 595-9. DOI: 10.1016 [PubMed 21402401].
17. Hopkins P.M., Reid C.G., Morley G.W. Radical Vulvectomy, the Decision for Incision. Cancer, 1993, Aug 1, vol. 72, no. 3, pp. 799-803.
18. Jacobs A.J., Stenson A.Vulvarand Vaginal Malignancies. Harvey J.C. Cancer Surgery. J.C. Harvey, E.J. Beattie. Philadelphia, 1996. Pp. 446-461.
19. Keys H. Gynecologic Oncology Group randomized trials of combined technique therapy for vulvar cancer. Cancer Supplement, 1993, Febyu 15, vol. 71, no. 4, pp. 1691-6 [PubMed 8431907].
20. Korlof B. Different methods of reconstruction after vulvectomies for cancer of the vulvae. Acta obstet. et gynecol. scand, 1975, vol. 54, no. 5, pp. 411-415.
21. Lai J., Elleray R., Nordin A. et al. Vulval cancer incidence, mortality and survival in England: age-related trends. Gynaecological oncology. BJOG 2014, DOI: 10.1111, 2013, Oct. 22, pp. 729-39 [PMID 24148762].
22. Matorras R., Diez J., Alonso M. et al. Morbimortalidad asociada al tratamiento quirurgico del cancer vulvar. Casuistica y revision. Clin. Invest. Ginecol. Obstet, 1991, vol. 18 (1), pp. 19-25.
23. Rhodes C.A., Shafi M.I. The management of squamous cell vulval cancer: A. population based retrospective study of 411 cases. Brit. J. Obstet. Gynaecol, 1998, vol. 105 (2), rr. 200-205.
24. Simonsen E. Treatment of recurrent squamous cell carcinoma of the vulvae. Acta radiol., 2. Sect.: Therapy, Physics, 1984, vol. 23, no. 5, pp. 345-348.
25. Sivanesaratnam V., Adlan A., Sinnathuray T.A. et al. Carcinoma of the vulva a Malaysian experience. Med. J. Malaysia, 1982, vol. 37 (2), pp. 170-174.
26. Straub H.G., Lampe D. Vulvakarzinom-Rezidivean der Universitats-Frauenklinik Halle ― S imZeitraum von 1971-90. Diagnose und Therapieergebnisse. Zbl. Gynakol, 1994. Bd 116, no. 12, pp. 675-678.
27. Vassilakos P., Spinosa G., Albe X., Krauer F. Recidiv du cancer de la vuivae: valeurpronostique de la marge chirrurgicale: Jahresversamml. Schweiz. Ges. Pathol. Schweiz. Med. Wochenschr, 1993, vol. 123, no. 40, p. 1912.
28. Zoltan Ya. Peresadka kozhi: perevod s vengerskogo [Skin Grafts: translation from Hungarian]. Vengriya: akademiya nauk, 1984. P. 304.