TY - JOUR
T1 - Multidisciplinary personalized approach in the management of vulvar cancer - The Vul.Can Team experience
AU - Tagliaferri, Luca
AU - Garganese, Giorgia
AU - D'Aviero, Andrea
AU - Lancellotta, Valentina
AU - Fragomeni, Simona Maria
AU - Fionda, Bruno
AU - Casà, Calogero
AU - Gui, Benedetta
AU - Perotti, Germano
AU - Gentileschi, Stefano
AU - Inzani, Frediano
AU - Corrado, Giacomo
AU - Buwenge, Milly
AU - Morganti, Alessio Giuseppe
AU - Valentini, Vincenzo
AU - Scambia, Giovanni
AU - Gambacorta, Maria Antonietta
AU - Macchia, Gabriella
PY - 2020
Y1 - 2020
N2 - Introduction Multidisciplinary treatment strategy involving adjuvant radiotherapy for advanced vulvar cancer could be useful in offering the best personalized clinical approach. In 2013, the VULvar CANcer Multi-Disciplinary Team (Vul.Can MDT) was set up in our institution, in order to share knowledge and expertise, high-quality diagnosis, and evidence-based decision making in the context of personalized medicine. The aim of this observational study was to report on our series of vulvar cancer patients managed postoperatively with radiotherapy within the framework of a formal multidisciplinary tumor board. Methods Coupling surgical and oncological international guidelines with case-by-case discussions, a multi-specialist consensus was progressively reached and internal recommendations were developed and introduced in the daily routine. Data from vulvar cancer patients who underwent primary surgery and adjuvant radiotherapy throughout a 5-year period were retrospectively collected. Actuarial local control was the primary endpoint, while secondary end-points were acute and late toxicities, disease-free survival, and overall survival. Toxicity was evaluated according to the Common Toxicity Criteria Adverse Event v 4.0 scale. Results The analysis included 35 patients with squamous vulvar cancer treated with adjuvant radiotherapy±chemotherapy, from April 2013 to September 2017. Median age was 70 years (range 18-87), all patients underwent surgery followed by concomitant chemoradiation (45.7%) or radiotherapy alone (54.3%). The median prophylactic dose on lymphatic drainage was 45 Gy, while positive nodes and perineal area received 51.2 Gy and 52.6 Gy, respectively. Chemotherapy involved the cisplatin-based regimen (45.7%)±5-fluorouracil (37.1%). Median follow-up was 32 months (range 6-72): the 24-months local control, disease-free survival, and actuarial overall survival rates were 88.6%, 82.0%, and 91.0%, respectively. Low rates of severe acute (12%) and late (3%) toxicities occurred. Discussion The outcomes of this series support the benefit of a multidisciplinary personalized approach in the management of vulvar cancer.
AB - Introduction Multidisciplinary treatment strategy involving adjuvant radiotherapy for advanced vulvar cancer could be useful in offering the best personalized clinical approach. In 2013, the VULvar CANcer Multi-Disciplinary Team (Vul.Can MDT) was set up in our institution, in order to share knowledge and expertise, high-quality diagnosis, and evidence-based decision making in the context of personalized medicine. The aim of this observational study was to report on our series of vulvar cancer patients managed postoperatively with radiotherapy within the framework of a formal multidisciplinary tumor board. Methods Coupling surgical and oncological international guidelines with case-by-case discussions, a multi-specialist consensus was progressively reached and internal recommendations were developed and introduced in the daily routine. Data from vulvar cancer patients who underwent primary surgery and adjuvant radiotherapy throughout a 5-year period were retrospectively collected. Actuarial local control was the primary endpoint, while secondary end-points were acute and late toxicities, disease-free survival, and overall survival. Toxicity was evaluated according to the Common Toxicity Criteria Adverse Event v 4.0 scale. Results The analysis included 35 patients with squamous vulvar cancer treated with adjuvant radiotherapy±chemotherapy, from April 2013 to September 2017. Median age was 70 years (range 18-87), all patients underwent surgery followed by concomitant chemoradiation (45.7%) or radiotherapy alone (54.3%). The median prophylactic dose on lymphatic drainage was 45 Gy, while positive nodes and perineal area received 51.2 Gy and 52.6 Gy, respectively. Chemotherapy involved the cisplatin-based regimen (45.7%)±5-fluorouracil (37.1%). Median follow-up was 32 months (range 6-72): the 24-months local control, disease-free survival, and actuarial overall survival rates were 88.6%, 82.0%, and 91.0%, respectively. Low rates of severe acute (12%) and late (3%) toxicities occurred. Discussion The outcomes of this series support the benefit of a multidisciplinary personalized approach in the management of vulvar cancer.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Carcinoma, Squamous Cell
KW - Chemoradiotherapy, Adjuvant
KW - Female
KW - Humans
KW - Margins of Excision
KW - Middle Aged
KW - Precision Medicine
KW - Radiotherapy, Adjuvant
KW - Retrospective Studies
KW - Vulvar Neoplasms
KW - Young Adult
KW - radiation oncology
KW - radiotherapy
KW - surgical oncology
KW - vulvar and vaginal cancer
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Carcinoma, Squamous Cell
KW - Chemoradiotherapy, Adjuvant
KW - Female
KW - Humans
KW - Margins of Excision
KW - Middle Aged
KW - Precision Medicine
KW - Radiotherapy, Adjuvant
KW - Retrospective Studies
KW - Vulvar Neoplasms
KW - Young Adult
KW - radiation oncology
KW - radiotherapy
KW - surgical oncology
KW - vulvar and vaginal cancer
UR - http://hdl.handle.net/10807/198621
U2 - 10.1136/ijgc-2020-001465
DO - 10.1136/ijgc-2020-001465
M3 - Article
SN - 1048-891X
VL - 30
SP - 932
EP - 938
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
ER -