Recurrence Patterns and Prognostic Factors in Chinese Patients With Squamous Cell Carcinoma of the Vulva Treated With Primary Surgery

Abstract

The purpose of this study was to identify the prognostic factors for disease-free survival (DFS) and recurrence patterns in Chinese women with squamous cell carcinoma of the vulva treated with primary surgery. From 1980 through 2002, 100 patients with invasive squamous cell carcinoma of the vulva treated with primary surgery were included in this retrospective study. Survival analyses included the Kaplan-Meier method, log-rank test, and Cox proportional hazards model. The 5- and 10-year DFS rates were 66.5% and 45.2%, respectively. Among all the tumor-related variables age, International Federation of Gynecology and Obstetrics stage, lymphovascular space invasion, and lymph node status were found to be significant predictors of DFS for the univariate analysis. Multivariate analysis proved that age (risk ratio, 6.572; 95% confidence interval, 1.759-24.546) and lymph nodes metastasis (risk ratio, 4.178; 95% confidence interval, 1.358-12.855) were the most significant prognostic factors of DFS (P < 0.05). The overall recurrence rate was 34.0% (34/100). Among the patients with recurrences, the locations of the recurrent disease were as follows: local recurrence in 20 (58.8%), groin recurrence in 2 (5.9%), local and groin in 1 (2.9%), distant metastases in 5 (14.7%), and local recurrence and distant metastases in 5 (14.7%); data were missing for 1 (2.9%) patients. Older age and lymph nodes metastases were the independent predictors of poor prognosis for patients with invasive squamous cell carcinoma of the vulva treated with primary surgery. Local recurrence was the main recurrence pattern after primary surgery which would be improved by multidisciplinary treatment.

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

“…This study together with several previous examinations has demonstrated that differentiation grade plays an important role in the aggressiveness of a tumor and has a considerable impact on survival [9, 10, 13, 14, 17, 27]. …”

“…Most of the available reports on prognostic factors in vSCC [13, 14] have included the analyses of cases treated with pelvic lymphadenectomy while it has been proven that such modality has negative influence on overall survival. Advantage of radiation to the pelvis in patients with positive inguinal lymph nodes as well as clinically suspected or fixed ulcerated groin nodes was confirmed in prospective randomized trials [22, 23].…”

“…While the data do seem to support that there is an important prognostic role for histologic grade for vSCC [9, 10, 13, 14, 17, 27], most pathologists have not yet incorporated this parameter into common practice schemes. Towards this end, it may be prudent to consider incorporating comments about histologic tumor grade as a routine component of the diagnostic reports of this malignancy.…”

The Role of Pathological Margin Distance and Prognostic Factors After Primary Surgery in Squamous Cell Carcinoma of the Vulva

“…12 A limited number of retrospective studies also identified other significant factors for recurrence and prognosis such as older age, tumor size, close surgical margin, stromal invasion, and adjuvant treatment. 4,13,14 To date, very limited data on the recurrence patterns and prognostic factors for survival after primary surgery T adjuvant therapy of squamous cell carcinoma of the vulva in the Turkish population exist. 15 The purpose of our study was to investigate the outcomes and evaluate the prognostic factors for recurrence and prognosis and the role of close margins in patients with squamous cell carcinoma of the vulva who were treated with primary surgery at our institution in the last 20 years.…”

Valor prognóstico da microdensidade vascular linfática intratumoral e da expressão neoplásica de podoplanina em carcinomas escamosos vulvares

“…O principal padrão de recorrência após cirurgia primária é a recorrência local, sendo que os preditores mais importantes de mau prognóstico são idade avançada e comprometimento linfonodal (4) . Cirurgia primária sem dissecção de linfonodo está associada a menor sobrevida geral e sobrevida livre de doença, juntamente com o estadiamento avançado e profundidade da invasão estromal acima de 9,0 mm (5) .…”