Vulvar field resection: novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy

Gynecologic Oncology
Michael HöckelNadja Dornhöfer

Abstract

Current local treatment of vulvar cancer is wide tumor excision and radical vulvectomy based on functional anatomy established from the adult and on the view of radial progressive tumor permeation. Standard surgery is associated with a considerable local failure rate and severe disturbance of the patients' body image. Vulvar field resection (VFR) is based on ontogenetic anatomy and on the concept of local tumor spread within permissive compartments. VFR combined with anatomical reconstruction (AR) is proposed as a new surgical approach to the treatment of vulvar cancer. A prospective trial was launched to test the compartment theory for vulvar cancer and to assess safety and effectiveness of the new therapy. In 54 consecutive patients 46 tumors were locally confined to the tissue compartment differentiated from the vulvar anlage. The 8 tumors having transgressed into adjacent tissue compartments of different embryonic origins exhibited signs of advanced malignant progression. 38 patients with vulvar cancer, stages T1-3 were treated with VFR and AR. The perioperative complication rate was low. At 19 (3-50) months follow-up no patient failed locally. 33 patients estimated their body image as undisturbed. Vulvar cancer permeates w...Continue Reading

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Citations

Feb 2, 2013·Journal of Obstetrics and Gynaecology of India·Attibele Palaksha Manjunath, Shivarudraiah Girija
May 20, 2011·Annals of Surgical Oncology·Linn WoelberSven Mahner
Jul 16, 2010·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·M Höckel
Apr 17, 2016·Insights Into Imaging·Inês A SantiagoRichard J Heald
Mar 11, 2015·The Lancet Oncology·Michael Höckel
Apr 2, 2013·Gynecologic Oncology·Michael Höckel, Lars-Christian Horn
Jul 19, 2013·Gynecologic Oncology·Angela Wills, Andreas Obermair
Nov 13, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Linn WoelberSven Mahner
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Jul 24, 2013·Expert Review of Anticancer Therapy·Sven MahnerLinn Woelber
Sep 21, 2017·International Urogynecology Journal·Aparna S RamaseshanTatiana V D Sanses
May 21, 2020·Archives of Gynecology and Obstetrics·Sophia TrottBenjamin Wolf
Apr 26, 2020·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Giulio SozziVito Chiantera

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