title: Prognostic factors in patients with carcinoma of the vulva--our own experience and literature review.
abstract: 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.
authors.affiliation: Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow Branch, Krakow, Poland. pawel.blecharz@interia.pl
authors.forename: P
authors.initials: P
authors.lastname: Blecharz
authors.forename: K
authors.initials: K
authors.lastname: Karolewski
authors.forename: T
authors.initials: T
authors.lastname: Bieda
authors.forename: M
authors.initials: M
authors.lastname: Klimek
authors.forename: J
authors.initials: J
authors.lastname: Pudelek
authors.forename: E
authors.initials: E
authors.lastname: Kojs
authors.forename: K
authors.initials: K
authors.lastname: Zur
authors.forename: P
authors.initials: P
authors.lastname: Dzialak
authors.forename: K
authors.initials: K
authors.lastname: Urbanski
mesh_terms: 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*