title: Investigation of the clinicopathological features of squamous cell carcinoma of the vulva: a retrospective survey of the Tohoku Gynecologic Cancer Unit.
abstract: BACKGROUND
  This multi-institutional study was conducted to clarify the clinicopathological features of squamous cell carcinomas of the vulva.
  
  
  METHODS
  The medical records of vulvar cancer patients treated between 2002 and 2012 were retrospectively reviewed following approval by the Institutional Review Board of each institution.
  
  
  RESULTS
  One hundred and eleven patients with vulvar malignancies were included. Of these, 63 patients had squamous cell carcinoma (57 %). Initial treatment was surgery, radiation therapy (RT), and concurrent chemoradiotherapy (CCRT) in 34 (54 %), 15 (24 %), and 11 (17 %) patients, respectively. Nineteen, 11, 26, and 7 patients had stage I, II, III, and IV disease, respectively. Of the 34 patients who had surgical treatment, 50 % had stage I disease, while 74 % of those who received CCRT had stage III or IV disease. Complete response (CR) rates for the surgery, RT, and CCRT groups were 73, 60, and 64 %, respectively. The 5-year survival rates for stage I/II and III/IV disease were 64 and 39 %, respectively (P = 0.019). The 5-year survival rates for the surgery, RT, and CCRT groups were 53, 38, and 50 %, respectively, and the prognosis of patients treated with surgery or CCRT was significantly better than that of patients who received RT (P < 0.05). In multivariate analysis, clinical response to initial treatment was an independent prognostic factor (P < 0.001).
  
  
  CONCLUSIONS
  Although many patients had advanced-stage disease in the CCRT group, the therapeutic outcome for the surgery and CCRT groups was similar. Thus, CCRT may be a promising treatment for squamous cell carcinoma of the vulva.
authors.affiliation: Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Futagami
authors.affiliation: Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan. yokoyama@cc.hirosaki-u.ac.jp.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Iino
authors.affiliation: Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Shoji
authors.affiliation: Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Department of Radiation Oncology, Iwate Medical University School of Medicine, Morioka, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Ariga
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tokunaga
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Tadao
authors.initials: T
authors.lastname: Takano
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Jingu
authors.affiliation: Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Terada
authors.affiliation: Department of Radiology and Radiation Oncology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Anbai
authors.affiliation: Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohta
authors.affiliation: Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kurachi
authors.affiliation: Department of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Kuroda
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishiyama
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Keiya
authors.initials: K
authors.lastname: Fujimori
authors.affiliation: Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Radiation Oncology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sato
authors.affiliation: Department of Gynecology, Miyagi Cancer Center, Natori, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Tase
authors.affiliation: Department of Radiation Oncology, Miyagi Cancer Center, Natori, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Mizunuma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000628:therapy; D055815:Young Adult
keywords: CCRT; Prognosis; Squamous cell carcinoma of the vulva; Surgery