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Prognostic factors in patients with vulvar cancer in the material of the Cracow Division of Centre of Oncology

Paweł Blecharz1, Krzysztof Urbański1, Kazimierz Karolewski1, Małgorzata Klimek1, Jacek Pudełek1, Tomasz Bieda1, Ewelina Kojs2

Affiliacja i adres do korespondencji
GIN ONKOL 2007, 5 (1), p. 22-28
Streszczenie

Aim of paper: Analysis of clinical material included 116 patients with vulvar cancer treated at the Cracow Division of the Centre of Oncology since 1990 thru 2003, aiming at assessment of treatment outcome and determination of prognostic factors. Material and methods: The patients’ mean age was 67 years. Microscopic study revealed highly differentiated tumour in 34.5%, medium differentiated tumour in 37.1% and non differentiated tumour in 28.4%. In 57.7% of patients, inguinal lymph nodes were clinically unaffected, while 42.3% of patients presented with unilateral or bilateral clinically evident lymph node metastases. 54.3% of patients had non advanced disease (I and II in the TNM scale), while the remaining 45.7% had advanced disease (III and IVA degree). One hundred four patients (89.7%) underwent primary surgical treatment, while the remaining 12 (10.3%) received radiotherapy only. Probability of survival was estimated using the Kaplan-Meier method and impact of selected factors on the patients’ survival was estimated using the Cox’s proportional hazard model. Results: Cumulative 5-year survival rate was 40.5%. For TNM clinical stages I-IVA this was 60.9%, 55%, 26.5% and 10.5%, respectively. For age groups under 70 and above 70 this was 52.9% and 22.9%, respectively, while considering inguinal lymph node status N0, N1 and N2 this was 52.2%, 30.0% and 15.8%, respectively. For histological tumour grades G1, G2 and G3, 5-year survival rates were 65%, 39.5% and 12.1%, respectively. Conclusions: Statistically significant unfavourable impact on 5-year symptom-free survival rate had: age above 70 years, poorly differentiated tumour (G3), clinically evident lymph node metastases and clinical stages III and IVA. Multivariate analysis by Cox revealed that independent prognostic factors for 5-year survival were patients’ age, clinical status of inguinal lymph nodes and TNM clinical stage of vulvar cancer.

Słowa kluczowe
vulvar cancer, prognostic factors, surgical treatment, irradiation, inguinal lymph nodes