Prognostic factors in patients with carcinoma of the vulva--our own experience and literature review.
OBJECTIVE
The objective was the analysis of prognostic factors and treatment outcomes of 104 patients with vulvar cancer, treated between 1990 and 2003 in the Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow, Poland.


METHODS
The median age of patients was 67. Advanced disease (TNM III and IVA) was found in 54 (51.9%) patients and grade 2 and 2 in 50 (48.1%). Inguinal lymph nodes were clinically uni- or bilaterally involved in 40.4% of patients. Fifty-seven (54.8%) patients underwent radical vulvectomy with bilateral inguinal lymphadenectomy and 47 (45.2%) radical vulvectomy only. Cancer differentiation was well in 38 (36.2%) of patients, moderate in 38 (36.2%) and poor in 28 (36.6%). Adjuvant radiotherapy was applied in 30 (28.8%) cases.


RESULTS
Five-year overall survival rate was observed in 44.4% of patients. Depending on TNM grade, 5-year OS rates were 61.4% for grade 1, 54.9% for grade 2, 40.1% for grade 3 and 13.3% for IVA. In patients aged < 70, 5-year OS rate was 54.7% compared to 30.5% for those > or = 70. Among patients with G1 cancer differentiation 64.4% survived five years, with G2 39.1% and with G3 24.9%, respectively.


CONCLUSIONS
Univariate analysis revealed a statistically significant, unfavorable impact of age > or = 70, with G3 cancer differentiation, clinically confirmed inguinal lymph node involvement and TNM classification stage on 5-year overall survival. Cox multivariate analysis demonstrated that independent prognostic factors for 5-year survival were the age of the patient, clinical status of inguinal lymph nodes and TNM classification grade.
Blecharz
P
P
Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow Branch, Krakow, Poland. pawel.blecharz@interia.pl
Karolewski
K
K
Bieda
T
T
Klimek
M
M
Pudelek
J
J
Kojs
E
E
Zur
K
K
Dzialak
P
P
Urbanski
K
K
D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D009367:Neoplasm Staging; D011044:Poland; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*