title: Outcome and patterns of recurrence for International Federation of Gynecology and Obstetrics (FIGO) stages I and II squamous cell vulvar cancer.
abstract: OBJECTIVE
  To study patterns of recurrence, to evaluate pathologic features correlating with recurrence, and to estimate the prognostic implications for each different pattern of recurrence in the International Federation of Gynecology and Obstetrics (FIGO) stages I and II squamous cell vulvar cancer.
  
  
  METHODS
  This was a retrospective study of 121 cases of vulvar cancer managed at our institution from 1987 to 2005. Time to recurrence, sites of local and distant recurrence, and the type of surgery were recorded. Relapse-free and overall survival were calculated.
  
  
  RESULTS
  There was no difference in recurrence rates, time to recurrence, or survival between patients with FIGO stages I or II disease. The 5-year actuarial survival (corrected for competing risks) for stage I disease was 97% compared with 95% for stage II (P=.83). Progression-free survival at 5 years was 86% for stage I and 94% for stage II.In this study, 95.9% of patients were treated with vulvar-conserving surgery without detriment with respect to recurrence or survival.
  
  
  CONCLUSIONS
  Vulvar-conserving surgery, even for large tumors, results in excellent outcomes. Vulvar recurrences have an excellent prognosis, but primary site and remote site vulvar recurrences are biologically different. There is no justification for the FIGO differentiation of node-negative cancers confined to the vulva on the basis of tumor size.
  
  
  METHODS
  III.
authors.affiliation: From the Gynaecological Cancer Centre, Royal Hospital for Women and University of New South Wales, Sydney, Australia; NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia; and Department Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Charuwan
authors.initials: C
authors.lastname: Tantipalakorn
authors.forename: Greg
authors.initials: G
authors.lastname: Robertson
authors.forename: Donald E
authors.initials: DE
authors.lastname: Marsden
authors.forename: Val
authors.initials: V
authors.lastname: Gebski
authors.forename: Neville F
authors.initials: NF
authors.lastname: Hacker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D018307:Neoplasms, Squamous Cell / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000601:surgery*