Prognostic factors and a value of 2009 FIGO staging system in vulvar cancer

Abstract

ObjectiveIn 2009, International Federation of Gynecology and Obstetrics (FIGO) modified staging of vulvar cancer—the prognostic significance of the new classification relative to the prior system as well as to the commonly recognized prognostic factors has not been assessed. The aim of this study was to test prognostic ability of 2009 staging in a cohort of uniformly treated and staged cases with long-term follow-up.MethodsPathologic characteristics were obtained by blind review of the original tissue samples. 76 patients who qualified for surgery on the basis of the same criteria, with full clinical history, were included in the study. The histological analyses were performed on 76 and 35 paraffin-embedded tissue samples from primary tumors and lymph nodes, respectively. Survival analyses included the Kaplan–Meier method, log-rank test and Cox proportional hazards model.ResultsUnivariate analysis has demonstrated that age (p = 0.0170), lymph node metastasis (p = 0.0393), tumor grade (p = 0.0086) and FIGO1994 stage (p = 0.001) were the significant prognostic factors for overall survival. Multivariate analysis has demonstrated that growing age (HR 2.25, 95 % CI 0.79–3.71, p = 0.0321), tumor grade (G1 vs. G2 and G3) (HR 1–3.11, 95 % CI 1.6–4.62, p = 0.0057) and FIGO1994 stage (HR 1.78, 95 % CI 0.55–3.01, p = 0.0061) are independent prognostic factors with respect to overall survival.ConclusionsThe results indicate the prognostic advantage of the 1994 FIGO staging as it has become an independent prognostic factor in contrast to the new FIGO system. This should be tested in future larger cohort studies. Differentiation grade turned out to be a very valuable independent prognostic factor and should be incorporated as a routine component of the histopathologic reports in vulvar cancer.

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

“…Similar findings were published by Blecharz and coworkers, revealing a 5-year overall survival rate of 30.5 % in patients over 70 years of age [21]. The impact of lymph node metastasis on the overall survival as presented by Sznurkowski et al was comparable to our series, with 50 % of all patients dying due to the disease within the first 20 months [22]. In the studies mentioned before, 5-year survival rate after pelvic exenteration was 54, ∼30 and 27,4 %, respectively [6,[16][17][18].…”

The effect of lymph node metastasis on overall survival and disease-free survival in vulvar cancer patients

“…The prognostic factors for vulvar cancer have been investigated in several studies [6][7][8]. Tumor invasion deeper than 2 mm was found to be a risk factor for local recur-rence [9].…”

Abdominopelvic washings in gynecologic pathology: A comprehensive review

“…13 From the first staging classification proposed by The League of Nations in 1937 to the more recent FIGO (2015) and American Joint Committee on Cancer (AJCC) Staging Manuel (2010) classifications, APW play no role in the staging of cancers of the uterine cervix. 16,18,19 In contrast to malignancies of the vulva, vagina, and uterine cervix, staging protocols for malignancies of the uterine corpus and ovary have taken into consideration APW cytology, and are currently considered an important factor in distinguishing between different stages of ovarian carcinoma. 16,17 Although some data suggest that histologic grade may play a prognostic role in the staging of vulvar cancer, APW cytology is not a component of staging of vulvar cancer.…”

“…16,17 Although some data suggest that histologic grade may play a prognostic role in the staging of vulvar cancer, APW cytology is not a component of staging of vulvar cancer. 16,18,19 In contrast to malignancies of the vulva, vagina, and uterine cervix, staging protocols for malignancies of the uterine corpus and ovary have taken into consideration APW cytology, and are currently considered an important factor in distinguishing between different stages of ovarian carcinoma. [20][21][22][23] Positive ascites fluid and APW show prognostic significance in ovarian carcinoma, and thus remain a significant part of staging.…”