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vulval cancer

S K Raghunath, H Nagaraja, N Srivatsa
Inguinal lymphadenectomy remains the standard of care for metastatic nodal disease in cases of penile, urethral, vulval and vaginal cancers. Outcomes, including cure rates and overall and progression-free survivals, have progressively improved in these diseases with extending criteria to offer inguinal lymph node dissection for patients 'at-risk' for metastasis or loco-regional recurrence. Hence, despite declining incidence of advanced stages of these cancers, many patients will still need to undergo lymphadenectomy for optimal oncological outcomes...
March 2017: Indian Journal of Surgical Oncology
Wiebren A A Tjalma, Vasiliki Siozopoulou, Manon T Huizing
BACKGROUND: Verrucous carcinoma of the vulva is extremely rare. It is a slow growing, low malignant variant of a squamous cell carcinoma with a cauliflower appearance. Women with lichen planus have an increased risk of developing vulval cancer. CASE PRESENTATION: A 79-year-old woman consulted for vulval itching. On clinical examination, a 3-cm large verrucous clitoral cancer in an area of lichen planus was seen. Based on her last clinical examination, the growth was estimated to be 1 cm(2) per month with an invasion depth after 6 months of 5 mm...
January 6, 2017: World Journal of Surgical Oncology
Kirstie Pye, Nicola Totton, Nicholas Stuart, Rhiannon Whitaker, Val Morrison, Rhiannon Tudor Edwards, Seow Tien Yeo, Laura J Timmis, Caryl Butterworth, Liz Hall, Tekendra Rai, Zoe Hoare, Richard D Neal, Clare Wilkinson, Simon Leeson
BACKGROUND: Gynaecological cancers are diagnosed in over 1000 women in Wales every year. We estimate that this is costing the National Health Service (NHS) in excess of £1 million per annum for routine follow-up appointments alone. Follow-up care is not evidence-based, and there are no definitive guidelines from The National Institute for Health and Care Excellence (NICE) for the type of follow-up that should be delivered. Standard care is to provide a regular medical review of the patient in a hospital-based outpatient clinic for a minimum of 5 years...
2016: Pilot and Feasibility Studies
G A Watson, D Kelly, L Prior, E Stanley, O MacEneaney, T Walsh, C M Kelly
Basal cell carcinoma (BCC) is the most common non-melanomatous skin cancer, typically arising in sun-exposed areas such as the head and neck. Defective signaling through the Hedgehog (HH) signaling pathway forms the molecular basis for BCC. Surgery remains the mainstay of treatment. Basal cell carcinoma of the genital tract is rare as is metastatic BCC. We report a case of metastatic BCC in a young woman with previously resected vulval BCC presenting six years later with inguinal nodal recurrence and multiple lung metastases...
November 2016: Gynecologic Oncology Reports
Sara Iacoponi, Patricia Rubio, Enrique Garcia, Martin K Oehler, Javier Diez, Begoña Diaz-De la Noval, Pablo Mora, Barbara Gardella, Ivan Gomez, Ioannis C Kotsopoulos, Kamil Zalewski, Ignacio Zapardiel
OBJECTIVE: The aim of this study was to analyze the prognostic factors related to the recurrence rate and overall survival of vulval melanoma patients by means of a subgroup analysis of the VULvar CANcer study. METHODS: The international multicenter VULvar CANcer study involved 100 international centers, which contributed 2453 vulvar cancer cases. Of the 1727 patients finally included in the study, 42 were suffering from vulvar melanoma (2.4%). RESULTS: The mean follow-up for vulval melanoma patients was 44...
September 2016: International Journal of Gynecological Cancer
Karen Lacey, James F Bishop, Hannah L Cross, Patty Chondros, Georgios Lyratzopoulos, Jon D Emery
OBJECTIVE: To assess variations in the number of general practitioner visits preceding a cancer diagnosis, and in the length of the interval between the patient first suspecting a problem and their seeing a hospital specialist. DESIGN, SETTING AND PARTICIPANTS: Analysis of data provided to the Cancer Patient Experience Survey (CPES; survey response rate, 37.7%) by 1552 patients with one of 19 cancer types and treated in one of five Victorian Comprehensive Cancer Centre hospitals, 1 October 2012 - 30 April 2013...
July 18, 2016: Medical Journal of Australia
Pierre Van Damme, Chris J L M Meijer, Dorothee Kieninger, Anne Schuyleman, Stephane Thomas, Alain Luxembourg, Martine Baudin
BACKGROUND: A nine-valent human papilloma virus (9vHPV) vaccine has been developed to prevent infections and diseases related to HPV 6/11/16/18 (as per the licensed quadrivalent HPV (qHPV) vaccine) as well as to five additional oncogenic HPV types (HPV 31/33/45/52/58). The 9vHPV vaccine has the potential to prevent 90% of cervical cancers, HPV-related anal, vaginal and vulval cancers and anogenital warts. We compared the immunogenicity and safety of the 9vHPV vaccine versus the qHPV vaccine in 16-26-year-old men...
July 29, 2016: Vaccine
Kate Coffey, Kezia Gaitskell, Valerie Beral, Karen Canfell, Jane Green, Gillian Reeves, Isobel Barnes
BACKGROUND: Vulval cancer predominantly affects postmenopausal women. A smaller proportion of vulval cancers, particularly at older ages, are now thought to be associated with human papillomavirus infection than previously reported, but other risk factors have not been well examined in prospective cohort studies. METHODS: A total of 1.3 million women aged 49-65 years were followed for incident vulval cancer (ICD-10 C51). Adjusted Cox regression models were used to examine the relationship between reproductive and lifestyle factors and risk of vulval cancer...
August 23, 2016: British Journal of Cancer
C Metheetrairut, B D Adams, S Nallur, J B Weidhaas, F J Slack
Elucidating the mechanisms involved in sensitizing radioresistant tumors to ionizing radiation (IR) treatments while minimizing injury to surrounding normal tissue is an important clinical goal. Due to their sequence-derived specificity and properties as gene regulators in IR-affected pathways, microRNAs (miRNAs) could serve as adjuvant therapeutic agents that alter cellular sensitivity to radiation treatment. To identify radiosensitizing miRNAs, we initially utilized the Caenorhabditis elegans vulval cell model, an in vivo system developed to study IR-dependent radiosensitivity as a measure of clonogenic cell death...
January 26, 2017: Oncogene
Timothy P Hanna, Geoffrey P Delaney, Michael B Barton
BACKGROUND: The population benefit of radiotherapy for gynaecological cancer (GC) if evidence-based guidelines were routinely followed is not known. This study's aim was to address this. METHODS: Decision trees were utilised to estimate benefit. Radiotherapy alone (RT) benefit was the absolute proportional benefit of radiotherapy over no radiotherapy for radical indications, and over surgery alone for adjuvant indications. Chemoradiotherapy (CRT) benefit was the absolute incremental benefit of concurrent chemotherapy and RT over RT alone...
September 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
S Philp, A Mellon, C Barnett, N D'Abrew, K White
Despite advances in surgical treatments and the availability of more conservative treatment options, women treated for vulval cancer still experience significant complications such as urinary incontinence, lymphoedema, pruritus, sexual and intimacy issues. These issues can profoundly impact a woman's quality of life. The subjective experience of women diagnosed and treated for vulval cancer in the literature is limited, possibly due to its comparable rarity to other gynaecological and female cancers and because it was traditionally seen mainly in the elderly female population...
February 18, 2016: European Journal of Cancer Care
Kalpana Ragupathy, Lisa Grandidge, Katie Strelley, Huan Wang, John Tidy
Vulval cancers are rare, but after primary treatment, known to recur with a high frequency (30%). Clinico-pathological predictors of recurrence have been established to a great extent. However, there is paucity of literature on predictors of early versus late recurrence. We sought to identify such predictors through a retrospective study of vulval cancer recurrences in a single cancer centre over 11 years. Age of women, depth of invasion/site of primary tumour and presence of background VIN/lichen sclerosus do not appear to affect timing of recurrence...
May 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Lauren L Lohmer, Matthew R Clay, Kaleb M Naegeli, Qiuyi Chi, Joshua W Ziel, Elliott J Hagedorn, Jieun E Park, Ranjay Jayadev, David R Sherwood
Invadopodia are specialized membrane protrusions composed of F-actin, actin regulators, signaling proteins, and a dynamically trafficked invadopodial membrane that drive cell invasion through basement membrane (BM) barriers in development and cancer. Due to the challenges of studying invasion in vivo, mechanisms controlling invadopodia formation in their native environments remain poorly understood. We performed a sensitized genome-wide RNAi screen and identified 13 potential regulators of invadopodia during anchor cell (AC) invasion into the vulval epithelium in C...
January 2016: PLoS Genetics
Theresa A Lawrie, Andy Nordin, Manas Chakrabarti, Andrew Bryant, Sonali Kaushik, Litha Pepas
BACKGROUND: Usual-type vulval intraepithelial neoplasia (uVIN) is a pre-cancerous condition of the vulval skin. Also known as high-grade VIN, VIN 2/3 or high-grade vulval squamous intraepithelial lesion (HSIL), uVIN is associated with high-risk subtype human papilloma virus (HPV) infection. The condition causes distressing vulval symptoms in the majority of affected women and may progress to vulval cancer, therefore is usually actively managed. There is no consensus on the optimal management of uVIN...
January 5, 2016: Cochrane Database of Systematic Reviews
Jennifer M Grants, Lisa T L Ying, Akinori Yoda, Charlotte C You, Hideyuki Okano, Hitoshi Sawa, Stefan Taubert
Cell signaling pathways that control proliferation and determine cell fates are tightly regulated to prevent developmental anomalies and cancer. Transcription factors and coregulators are important effectors of signaling pathway output, as they regulate downstream gene programs. In Caenorhabditis elegans, several subunits of the Mediator transcriptional coregulator complex promote or inhibit vulva development, but pertinent mechanisms are poorly defined. Here, we show that Mediator's dissociable cyclin dependent kinase 8 (CDK8) module (CKM), consisting of cdk-8, cic-1/Cyclin C, mdt-12/dpy-22, and mdt-13/let-19, is required to inhibit ectopic vulval cell fates downstream of the epidermal growth factor receptor (EGFR)-Ras-extracellular signal-regulated kinase (ERK) pathway...
February 2016: Genetics
Hua Tu, He Huang, Jihong Liu
OBJECTIVE: To systematically review the clinical value of sentinel lymph node biopsy (SLNB) in diagnosis of lymph node metastasis in early-stage squamous cell carcinoma of vulva. METHODS: Cochrane library, biomedical database (EMbase), PubMed, China national knowledge internet (CNKI), Wang Fang database, «Gynecologic Oncology», «National Medical Journal of China» and «Chinese Journal of Obstetrics and Gynecology» were searched for literatures from 1990 to 2014 concerning SLNB application in early-stage vulvar squamous cell carcinoma...
September 1, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Rachel Louise O'Donnell, Katherine M Clement, Richard J Edmondson
PURPOSE OF REVIEW: Provision of hormone replacement therapy (HRT) to women following a diagnosis of a gynaecological malignancy is a complex and controversial area associated with a lack of published guidance. As the average age of women affected by gynaecological cancer decreases and survival following provision of effective therapies increases, clinicians face new considerations for longer-term health concerns of patients. Additionally, there is a growing understanding of the influence of tumour biology upon response to cytotoxic therapies and it is essential that we use this knowledge to guide provision of HRT...
February 2016: Current Opinion in Obstetrics & Gynecology
Gemma L Owens, Henry C Kitchener
Cervical intraepithelial neoplasia (CIN) is the most common premalignant disease of the lower genital tract encountered during pregnancy. As in the non-pregnant state, abnormal cytology should be referred for colposcopy. However, the role of colposcopy in pregnant women is to exclude invasive cancer by visual inspection and defer biopsy and definitive treatment until the post-partum period. Colposcopic exclusion of invasive disease is the only absolute indication for conisation in pregnancy. It is now evident that treatment for CIN outside of pregnancy, that involves >15 mm deep excision is associated with an increased risk of preterm delivery...
May 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
San Soo-Hoo, David Luesley
Lower genital tract malignancy during pregnancy is rare. Due to the rarity of this condition, the best evidence in its management is based on case reports. The management of the lower genital tract malignancy is influenced by factors including oncological factors, maternal and foetal effect of treatment, and other religious and ethical issues in a multidisciplinary approach. In most cases, the woman can continue with the pregnancy. This chapter describes the management of vaginal and vulval cancer during pregnancy based on available case reports...
May 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
John Doorbar
Human papillomaviruses (HPVs) cause a range of serious diseases, including the vast majority of cervical cancers, most anal cancers and around half of head and neck cancers. They are also responsible for troublesome benign epithelial lesions, including genital warts and laryngeal papillomas, and in some individuals HPVs lead to recurrent respiratory papillomatosis and other difficult-to-manage diseases. As a result, there is a great need for model systems that accurately mimic papillomavirus infections in humans...
January 2016: Journal of Pathology
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