Does plastic surgical consultation improve the outcome of XXXX undergoing radical vulvectomy for squamous cell carcinoma of the vulva?

@entity1 @entity1544 @entity5
OBJECTIVES: To analyze margin status and prognostic factors for complications in @entity1 undergoing vulvectomy for invasive @entity1544 (iSCC) with and without plastic-assisted closure. METHODS: Demographic and clinical data were collected on 94 @entity1 with iSCC who underwent vulvectomy between 2004 and 2013. All pathology slides were re-reviewed by two gynecologic pathologists. Data were analyzed using XLSTAT-Pro v2014.2.02. RESULTS: Of 88 eligible @entity1 , 15 (17%) had plastic-assisted vulvar closure and 73 (83%) did not. There were significantly more @entity1 in the plastics group with recurrent disease (53% v 10%) and history radiation therapy prior to surgery (40% versus 5%). Plastic-assisted closure was associated with larger @entity5 (3.73cm versus 2.03cm, p<0.01) and a higher frequency of adequate margins (53% versus 29%, p=0.06). For @entity5 >= 3.0cm, plastic-assisted closure was significantly associated with adequate margins (44% versus 6%, p=0.03). Prior radiation use was associated with plastic-assisted closure, larger @entity5 , older age, and recurrent disease. Complications occurred in 36 @entity1 (41%) and significantly more occurred in those with plastic-assisted closure (67% versus 36%, p=0.04). On multivariate analysis including age, @entity5 size, recurrent disease, plastic-assisted closure, and history of radiation, only history of radiation therapy was a significant predictor of complications (OR=17, 95%CI 2.05-141.35; p=0.01). CONCLUSIONS: Plastic-assisted vulvectomy closure was more often utilized in cases involving @entity5 . Plastic-assisted closure significantly increased the frequency of adequate margins in @entity5 >= 3cm and did not impact complications.
