title: Study of biomolecular and clinical prognostic factors in patients with cancer of the vulva undergoing surgical treatment.
abstract: BACKGROUND
  Cancers of the vulva account for 3% to 5% of all cancers of the female genital. This study was conducted to evaluate clinical, pathological, and molecular prognostic factors in patients with cancer of the vulva.
  
  
  METHODS
  Patients with squamous cell carcinoma of the vulva who had undergone surgical treatment at the Department of Pelvic Surgery and Gynecology Service, Aristides Maltez Hospital, between June 1993 and June 2011 were selected. Clinical, epidemiological, pathological, and molecular characteristics related to the prognosis of these patients were evaluated in relation to the prognosis. In the molecular evaluation, we studied the expression of p53 and matrix metalloproteinase 2 by immunohistochemistry.
  
  
  RESULTS
  Seventy-five patients were eligible for the study. In multivariable analysis, factors related to survival were as follows: tumor size larger than 4 cm (P = 0.014), an invasion depth greater than 2 mm (P = 0.023) and matrix metalloproteinase 2 expression in more than 50% of the tumor cells (P = 0.046). With the use of the relative risks of the factors identified in the multivariable analysis, a point count was developed for a prognostic classification (the score classifies patients into 3 categories).
  
  
  CONCLUSIONS
  A tumor size larger than 4 cm, an invasion depth greater than 2 mm, and metalloproteinase 2 expression in more than 50% of the tumor cells seem to be related to lower overall survival rate in patients with cancer of the vulva undergoing surgical treatment. A classification of the patient's prognosis can be performed using a point count based on these relative risks.
authors.affiliation: *Department of Gynecology Oncology, and †Gynecologic Oncology Service, Hospital Aristides Maltez; and ‡Department of Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Zanvettor
authors.forename: Deraldo Fernando Falcão
authors.initials: DF
authors.lastname: Filho
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
authors.forename: Adson Roberto Santos
authors.initials: AR
authors.lastname: Neves
authors.forename: Leonardo Oliveira
authors.initials: LO
authors.lastname: Palmeira
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D046888:Tissue Array Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D014846:Vulvar Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2