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Analysis of prognostic factors in vulvar cancer, with special emphasis on FIGO 2009 staging classification – results of own study and literature review

Sylwia Koryga-Wszołek1, Paweł Wojas2, Ewa Iwańska3, Maja Janeczek3, Kazimierz Karolewski3, Wiktor Szatkowski3, Paweł Blecharz3
Affiliacja i adres do korespondencji
Curr Gynecol Oncol 2017, 15 (3), p. 157–171
DOI: 10.15557/CGO.2017.0016
Streszczenie

Aim: The study is aimed at the analysis of prognostic factors in a group of 160 patients with vulvar cancer managed with primary surgery at the Center of Oncology, Maria Skłodowska-Curie Memorial Institute, Cracow Branch, with special emphasis on the prognostic value of FIGO 2009 staging classification for vulvar cancer. Material and method: The clinical data of patients affected with invasive vulvar cancer treated with primary surgery at the Center of Oncology, Maria Skłodowska-Curie Memorial Institute, Cracow Branch in the years 1985–2009. In 6 (3.8%) patients, partial radical vulvectomy and unilateral lymphadenectomy were performed, in 65 (40.6%) – complete radical vulvectomy and unilateral lymphadenectomy, and in 89 (55.6%) – complete radical vulvectomy and bilateral lymphadenectomy. The survival probability was estimated with the Kaplan–Meier method, and the Cox proportional hazards model was used to evaluate the effect of selected factors on patient survival. Results: The mean follow-up time was 9 years (range 0.6–23 years). The 5-year survival rate equaled 45.6%. Multivariate analysis showed patients with cancer spread to inguinal lymph nodes to be characterized by an over 15 times higher risk of death than patients without lymph node metastases. In univariate analysis, the use of FIGO 2009 staging classification for vulvar cancer deteriorated the outcomes for stage IB patients compared with FIGO 1988 classification, with 5-year survival rates amounting to 69% and 88%, respectively. No differences in outcomes were identified for the remaining FIGO stages compared between the two classifications. Conclusions: The microscopic status of regional lymph nodes was identified as the sole independent prognostic factor of 5-year overall survival rates.

Słowa kluczowe
vulvar cancer, prognostic factors, surgical management