title: Vulvar cancer: prognostic factors.
abstract: BACKGROUND
  Prognostic factors such as surgery and pathology in vulvar squamous cell carcinoma are studied.
  
  
  METHODS
  47 patients with vulva squamous cell carcinoma treated at the Gynecology Department of the University of Padua, have been retrospectively studied.
  
  
  RESULTS
  At the univariate relapse-free survival analysis, a significant association was found for histological grade, stage of disease and type of surgery. All patients presented vulvar squamous cell carcinoma: G(1) in 25 (53%), G(2) in 14 (30%), and G(3) in 8 (17%) patients. The distribution of stages was as following: stage 1 in 6 (13%), stage 2 in 20 (43%), stage 3 in 11 (23%), and stage 4 in 10 patients (21%). Radiotherapy was performed in 13 patients. Among the 47 patients evaluable: 26 (55.3%) developed local recurrence, 12 of these patients developed a second local relapse, 3 of these also had distant metastases (lung in 1 patient, lomboaortic and mediastinic lymph nodes in the other 2 patients). Stromal invasions were <or=9 mm in 14 patients with 6 relapses and >9 mm in 30 patients with 27 relapses (univariated analysis p=0 0066). Five episodes (10,6%) of thrombosis were observed.
  
  
  CONCLUSIONS
  After multivariate analysis, surgery, stage and stromal invasion over 9 mm (hazard ratio=3.1; 95% confidence interval: 1.3-7.7) proved to be the most dominant predictor for relapse-free survival. Histological grades 1 and 2 were predictive of better disease-free survival (p=0.0012).
authors.affiliation: Medical Oncology Unit, Istituto Oncologico Veneto - IRCCS, Via Gattamelata, 64, 35128 Padova, Italy.
authors.forename: Maria Ornella
authors.initials: MO
authors.lastname: Nicoletto
authors.forename: Anna
authors.initials: A
authors.lastname: Parenti
authors.forename: Paola
authors.initials: P
authors.lastname: Del Bianco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lombardi
authors.forename: Lucia
authors.initials: L
authors.lastname: Pedrini
authors.forename: Sara
authors.initials: S
authors.lastname: Pizzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Carli
authors.forename: Maurizia
authors.initials: M
authors.lastname: Della Palma
authors.forename: Davide
authors.initials: D
authors.lastname: Pastorelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Corti
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Becagli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology; D014846:Vulvar Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy