RT Journal Article SR Electronic T1 Two-team Simultaneous Total Radical Vulvectomy and Inguino-femoral Lymphadenectomy via Separate Incisions for Locally Advanced (FIGO Stages IB ≥4 cm–III) Squamous Vulvar Cancer JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 7345 OP 7350 VO 34 IS 12 A1 MASSIMILIANO FAMBRINI A1 FLAVIA SORBI A1 GIOVANNI SISTI A1 VANNI CHECCUCCI A1 GIUSEPPE CARITI A1 VIERI SCOTTI A1 ELETTRA TINACCI A1 IRENE TURRINI A1 MASSIMO MICAGLIO A1 ANGELINA DE MAGNIS YR 2014 UL http://ar.iiarjournals.org/content/34/12/7345.abstract AB Aim: To describe the feasibility, safety, and oncological outcomes of a modified triple-incision total radical vulvectomy and inguino-femoral lymphadenectomy in patients with locally advanced squamous vulvar cancer. Patients and Methods: A modified triple-incision technique performed by two surgical teams operating simultaneously under regional anesthesia was performed on a consecutive series of 57 patients with Fédération Internationale de Gynécologie Ostétrique (FIGO) stages IB ≥4 cm to III squamous vulvar cancer. Adjuvant radiation therapy was delivered according to margin status and groin involvement. Surgical outcomes and follow-up data were retrospectively analyzed. Results: The mean age of patients was 75.5±10.7 years and 54 (94.7%) had at least one comorbidity. Fifteen (26.3%) had disease of clinical FIGO stage I ≥4 cm, 7 (12.3%) had stage II, and 35 (61.4%) had a stage III. All surgical procedures were completed as planned. The mean surgical duration was 108±37 min. Major intraoperative complications were observed in two cases (3.5%). Twenty-one (36.8%) patients received adjuvant radiation therapy. During a mean follow-up of 51.6±50.5 months, 29 (50.9%) patients developed local, regional or distant recurrence. The disease-free survival was 39.5±20.9 months. Nineteen (33.3%) patients died of primary disease. Overall survival for the entire cohort was 65.4%, with 3-year and 5-year overall survival of 60.5% and 48.6%, respectively. Conclusion: Our results seem to reveal that the procedure is safe, with surgical and oncological outcomes comparable to classic sequential triple-incision technique. The shortening of surgical duration along with the use of regional anesthesia can have significant advantages for perioperative care, reducing the global burden of treatment and increasing the number of patients eligible for therapeutic surgery.