A preliminary report on a histologic malignancy grading of vulvar carcinoma is presented. A retrospective histologic study of 40 vulvar carcinoma cases stage I and II (TNM-system) with a minimum five-year follow-up was carried out and correlated to the course of the disease. Morphologic criteria characterizing the tumor cell population, as well as the tumor-host relationship, were examined and scored. The scores obtained could be divided into three groups that correlated well with the clinical outcome. The low-score group had no metastases or recurrence, whereas 82% of the high-score group had both metastases and fatalities. Depth of invasion was found to have a strong correlation to clinical outcome. A more accurate morphologic malignancy grading of such carcinomas could lead to a more individual and often less radical treatment plan.
Histological malignancy grading and its correlation to prognosis were retrospectively investigated in 303 cases of squamous cell carcinoma of the vulva. A scoring system based on several variables is suggested. The scores and the individual histological variables were tested along with clinical factors with a view to predicting survival. Various histological variables including mode of invasion, depth of invasion and nuclear polymorphism, as well as the sum of the scores were good predictors of survival. The study revealed a significantly better survival rate in stage III if no metastases were suspected. An age factor was also found showing that cancer of the vulva has a worse prognosis in older women.
Histologic malignancy grading and prognosis from a biopsy only was retrospectively investigated in 92 cases of stages I and II of cancer of the vulva treated with electrocoagulation. A scoring was made of several histologic variables. The score proved to be a better predictor of survival than any other single factor analysed, including clinical staging. Depth of invasion did not significantly influence survival, thus indicating improper use of "microinvasion", if defined only by depth of invasion.
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