<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412018000700423</article-id>
<article-id pub-id-type="doi">10.24245/gom.v86i7.2187</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cáncer de vulva. Repercusiones del tratamiento quirúrgico: experiencia con 151 pacientes]]></article-title>
<article-title xml:lang="en"><![CDATA[Vulvar cancer. Impact of surgical treatment: experience with 151 patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres-Lobatón]]></surname>
<given-names><![CDATA[Alfonso]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vázquez-Tinajero]]></surname>
<given-names><![CDATA[Azcary]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez-Arroyo]]></surname>
<given-names><![CDATA[Elisa Paola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barra-Martínez]]></surname>
<given-names><![CDATA[Rosalva]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliva-Posada]]></surname>
<given-names><![CDATA[Juan Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morgan-Ortiz]]></surname>
<given-names><![CDATA[Fred]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de México Dr. Eduardo Liceaga Unidad de Ginecología Oncológica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de México Dr. Eduardo Liceaga  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General de México Dr. Eduardo Liceaga  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital General de México Dr. Eduardo Liceaga Unidad de Ginecología Oncológica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Autónoma de Sinaloa Centro de Investigación en Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<volume>86</volume>
<numero>7</numero>
<fpage>423</fpage>
<lpage>433</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412018000700423&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412018000700423&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412018000700423&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: Reportar la experiencia institucional en el tratamiento quirúrgico de pacientes con cáncer de vulva de acuerdo con la clasificación vigente de la Federación Internacional de Ginecología y Obstetricia (FIGO).  Materiales y métodos: Análisis retrospectivo de expedientes de pacientes con diagnóstico de carcinoma vulvar operadas con o sin coadyuvancia en el servicio de Oncología del Hospital General de México en un lapso de 34 años. Para el análisis estadístico se utilizó el programa Epi Info versión 7.2.  Resultados: Se incluyeron 151 pacientes: 24 (16%) con lesiones preinvasoras o con mínima invasión, se intervinieron con escisiones locales o vulvectomías simples; 16 (15%) con cánceres invasores en quienes se efectuó cirugía conservadora de la vulva con o sin disección ganglionar unilateral. En 94 (62%) se efectuaron vulvectomías con linfadenectomías: 47 con cirugías en bloque y 47 mediante incisiones separadas. En 11 (%) pacientes se practicaron cirugías ultrarradicales: 6 resecciones abdominoperineales y 5 exenteraciones pélvicas. De 127 pacientes que tuvieron seguimiento, 62 (49%) evolucionaron 30 meses en promedio sin evidencia de enfermedad. Se incluyen 21/23 (91%) lesiones tempranas (VIN 2,3 y I- A); 37/49, (76%) de las invasoras en estadios IB-II; 13/41, (32%) de los estadios III (p = 0.00007) y 3/14 (21%) de los IV-A.  Conclusiones: Si bien la tendencia actual se orienta a individualizar el tratamiento quirúrgico de pacientes con cáncer de vulva invasor, en esta serie solo en 15% fueron cirugías conservadoras. La metástasis ganglionar fue el factor pronóstico más desfavorable.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: The present study is a review of our experience of the surgical options for vulvar cancer using The International Federation of Gynecology and Obstetrics (FIGO) classification.  Materials and methods: Retrospective analysis of records of patients diagnosed with vulvar carcinoma operated with or without coadyuvance in the Oncology service of the General Hospital of Mexico in a span of 34 years. For the statistical analysis, the Epi Info version 7.2 program was used.  Results: Patients were divided into groups, those with pre-invasion or minimal invasion disease were resolved with local excision or simple vulvectomy 24 (16%). Patients with invasive cancer were treated with conservative surgery with or without unilateral lymph node dissection 16 (15%); radical vulvectomy with inguino femoral lymphadenectomy 94 (62%) (47 block surgeries and 47 with separate incision); ultra-radical surgery 11 (7%) (6 abdomino-perineal resections and 5 pelvic exenterations). 127 patients had follow-up and 62 of them had a disease-free survival rate of 30 months (48.8%). The overall survival in pre-invasion or minimal invasion disease were 91.3% (21/23), in stage IB-II 75.5% (37/49), in stage III 31.7% (13/41) (p=0.00007) and in stage IVA 21.4% ( 3/14 ).  Conclusions: Although a more individualized and less radical treatment is suggested, in this series only 14.5% of patients, could be resolved with conservative surgery. In addition, the lymph node status was the most important prognostic factor for survival.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cáncer de vulva]]></kwd>
<kwd lng="es"><![CDATA[vulvectomía]]></kwd>
<kwd lng="es"><![CDATA[disección unilateral ganglionar]]></kwd>
<kwd lng="es"><![CDATA[vulvectomía radical]]></kwd>
<kwd lng="es"><![CDATA[linfadenectomía femoral]]></kwd>
<kwd lng="es"><![CDATA[exenteraciones pélvicas]]></kwd>
<kwd lng="en"><![CDATA[Vulvar cancer]]></kwd>
<kwd lng="en"><![CDATA[Vulvectomy]]></kwd>
<kwd lng="en"><![CDATA[Unilateral lymph node dissection]]></kwd>
<kwd lng="en"><![CDATA[Limphadenectomy]]></kwd>
<kwd lng="en"><![CDATA[Pelvic exenterations]]></kwd>
</kwd-group>
</article-meta>
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