Abstract
BackgroundThe purpose of the study was to determine whether inclusion of computerized tomography (CT) in the prospective evaluation of vulvar cancer changed the surgical treatment strategy in terms of detection of lymph node metastases, tumor spread and comorbidity, and additionally to examine the logistical influence of adding further examinations prior to treating out-hospital patients referred from geographically distant areas.MethodsDuring an 8 month period we conducted a prospective study of patients with newly diagnosed or recurrent vulvar cancer consecutively referred to Copenhagen University Hospital, Rigshospitalet. The patients underwent a gynecological examination, chest x-ray and a preoperative CT scanning of the chest, abdomen and pelvis. It was registered whether the radiological findings regarding the extent of the tumor, lymph node involvement, incidental findings and comorbidity changed the surgical treatment plan. Further, the logistical influence of the long referral distances was registered.ResultsThirty patients with a median age of 69 years (range 44–93 years) were included in the study. CT did not significantly change the initial surgical treatment plan for the patients. CT did not reveal lymph node enlargement outside the inguinofemoral area and was inaccurate compared to the sentinal node examination of the local lymph nodes. CT diagnosed no cases with distant metastases from the primary malignancy, but two cases with a secondary malignant disease were found.ConclusionsCT scanning has no clinical impact as a routine screening examination prior to surgery. It may delay treatment, but can add important information when clinically indicated.
Highlights
The purpose of the study was to determine whether inclusion of computerized tomography (CT) in the prospective evaluation of vulvar cancer changed the surgical treatment strategy in terms of detection of lymph node metastases, tumor spread and comorbidity, and to examine the logistical influence of adding further examinations prior to treating out-hospital patients referred from geographically distant areas
All patients were scheduled for a CT scan on the same day or the day after the initial examination
Chest x-ray and clinical evaluation supplemented with sentinel node examination for local lymph node involvement is generally sufficient in patients without signs of advanced disease
Summary
The purpose of the study was to determine whether inclusion of computerized tomography (CT) in the prospective evaluation of vulvar cancer changed the surgical treatment strategy in terms of detection of lymph node metastases, tumor spread and comorbidity, and to examine the logistical influence of adding further examinations prior to treating out-hospital patients referred from geographically distant areas. Andersen et al Cancer Imaging (2015) 15:8 surgical procedure and the final outcome of the patients, including identification of lymph node metastases and probable comorbidity and incidental findings detected [8,9,10,11]. The final stage of the disease is determined by the combined gynecological, pathological and radiological findings, in accordance to the revised guidelines proposed by the International Federation of Gynecology and Obstetrics (FIGO) [12, 13]. Whether identified comorbidity and incidental findings will moderate or change the scheduled surgical treatment plan or follow-up[14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
