title: The impact of performance status on survival in patients of 80 years and older with vulvar cancer.
abstract: OBJECTIVE
  There are no data available on the impact of performance status on outcome in patients with vulvar cancer. It was the objective of this study to determine the impact of performance status on survival in a group of elderly patients.
  
  
  METHODS
  A retrospective review of records of patients with vulvar cancer aged 80 years or greater and treated in a gynecological referral center was performed. Multiple clinical and pathological variables together with performance status were assessed and the impact on overall survival was determined both by univariate and multivariate analysis.
  
  
  RESULTS
  Of 75 patients aged 80 years or older, 57 (76%) had standard treatment. The patients who had standard treatment were characterized by an earlier clinical stage and a better performance status compared with patients who had nonstandard treatment. When preoperatively available parameters of all patients were assessed in relation to survival in the total group, Eastern Cooperative Oncology Group (ECOG) performance status was the only independent prognostic indicator for survival. When all clinical and histopathological variables were assessed in the subgroup who had standard treatment, both ECOG performance status and extracapsular lymph node involvement were independent prognostic variables for overall survival. Age was not a significant prognostic variable.
  
  
  CONCLUSIONS
  ECOG performance status is the only available pretreatment variable with independent prognostic value for survival in this group of elderly patients with vulvar cancer. These data show the importance of individualizing the treatment of patients with vulvar cancer. Performance status takes a more important place than age in the management process of these patients.
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
authors.forename: Simon E
authors.initials: SE
authors.lastname: Hyde
authors.forename: Anca C
authors.initials: AC
authors.lastname: Ansink
authors.forename: Matthé P M
authors.initials: MP
authors.lastname: Burger
authors.forename: Marten S
authors.initials: MS
authors.lastname: Schilthuis
authors.forename: Jacobus
authors.initials: J
authors.lastname: van der Velden
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014846:Vulvar Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy