Int J Med Sci 2020; 17(16):2578-2584. doi:10.7150/ijms.49804

Research Paper

Comparison of two types of the triple incision technique in the treatment of patients with locally advanced vulvar cancer

Ying Ma1,3*, Wei-feng Liang2,3*, Chang-hao Liu3, Zhong-qiu Lin3, Miao-fang Wu3✉, Jing Li3✉

1. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Dalian Medical university, Dalian, 116011, People's Republic of China.
2. Department of Gynecology and Obstetrics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, 266035, People's Republic of China.
3. Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People's Republic of China.
*These authors contributed equally to this work.

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Citation:
Ma Y, Liang Wf, Liu Ch, Lin Zq, Wu Mf, Li J. Comparison of two types of the triple incision technique in the treatment of patients with locally advanced vulvar cancer. Int J Med Sci 2020; 17(16):2578-2584. doi:10.7150/ijms.49804. Available from http://www.medsci.org/v17p2578.htm

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Abstract

Objective: In 2012, we proposed and described a modified triple incision technique (MTIT) for vulvar cancer patients with locally advanced disease. The MTIT has undergone a series of modifications, and a modified MTIT (M-MTIT) has been developed. The purpose of this study was to introduce the M-MTIT and compare it with the MTIT.

Study design: This was a retrospective cohort study. Fifty-seven vulvar cancer patients with clinical stage T2 (≥ 4 cm) or T3 disease were included. Of these patients, 28 underwent the MTIT and 29 underwent the M-MTIT. Data on surgery-related complications and survival outcomes were compared.

Results: Patients who were treated with the M-MTIT developed significantly less surgery-related morbidities than patients treated with the MTIT (24.1% vs. 60.7%, P = 0.005). Wound breakdown was the most common complication in our cohort, which occurred less frequently in the M-MTIT group than in the MTIT group (10.3% vs. 35.7%, P = 0.022). Multivariate logistic regression analysis identified the M-MTIT as an independent predictor of a reduced risk of wound breakdown. The incidence of other complications, including lymphedema, wound infection and cellulitis, was lower in the M-MTIT group than in the MTIT group; however, the differences did not reach statistical significance. The median follow-up time of this study was 33 months. Kaplan-Meier survival graphs did not show significant differences in recurrence-free survival or overall survival between the two groups.

Conclusions: The M-MTIT correlates with lower morbidity rates than the MTIT and does not compromise oncological safety. The M-MTIT can be considered a safe and feasible option for vulvar cancer patients with locally advanced disease.

Keywords: vulvar cancer, triple-incision technique, complication, survival