Prognostic factors in patients with vulvar cancer: the VULCAN study

被引：42

作者：

Zapardiel, Ignacio ^{[1
]}

Iacoponi, Sara ^{[1
]}

Coronado, Pluvio J. ^{[2
]}

Zalewski, Kamil ^{[3
]}

Chen, Frank ^{[4
]}

Fotopoulou, Christina ^{[4
,6
]}

Dursun, Polat ^{[5
]}

Kotsopoulos, Ioannis C. ^{[6
]}

Jach, Robert ^{[7
]}

Buda, Alessandro ^{[8
]}

Martinez-Serrano, Maria J. ^{[9
]}

Grimm, Christoph ^{[10
]}

Fruscio, Robert ^{[8
]}

Garcia, Enrique ^{[11
]}

Sznurkowski, Jacek Jan ^{[12
]}

Ruiz, Cristina ^{[13
]}

Noya, Maria C. ^{[14
]}

Barazi, Dib ^{[15
]}

Diez, Javier ^{[16
]}

Diaz de la Noval, Begona ^{[17
]}

Bartusevicius, Arnoldas ^{[18
]}

De Iaco, Pierandrea ^{[19
]}

Otero, Maria ^{[20
]}

Diaz, Maria ^{[21
]}

Haidopoulos, Dimitrios ^{[22
]}

Franco, Silvia ^{[23
]}

Blecharz, Pawel ^{[24
]}

Zuniga, Miguel A. ^{[25
]}

Rubio, Patricia ^{[26
]}

Gardella, Barbara ^{[27
]}

Papatheodorou, Dimitrios C. ^{[28
]}

Yildirim, Yusuf ^{[29
]}

Fargas, Francesc ^{[30
]}

Macuks, Ronalds ^{[31
]}

机构：

[1] La Paz Univ Hosp IdiPAZ, Gynecol Oncol Unit, Madrid, Spain

[2] Hosp Clin Univ San Carlos IdISSC, Gynecol Dept, Madrid, Spain

[3] Maria Sklodowska Curie Mem Canc Ctr, Inst Oncol, Gynecol Oncol Dept, Warsaw, Poland

[4] Charite Univ Med Berlin, Campus Virchow Klinikum, Dept Gynecol, Berlin, Germany

[5] Baskent Univ, Sch Med, Div Gynecol Oncol, Dept Obstet & Gynecol, Ankara, Turkey

[6] Theagenio Canc Hosp, Gynecol Oncol Dept, Thessaloniki, Greece

[7] Jagiellonian Univ, Univ Hosp, Gynecol Dept, Krakow, Poland

[8] Hosp San Gerardo, Gynecol Oncol Dept, Monza, Lombardia, Italy

[9] Vall dHebron Inst Oncol, Gynecol Oncol Unit, Barcelona, Spain

[10] Med Univ Vienna, Vienna Gen Hosp, Div Gen Gynaecol & Gynaecol Oncol, Vienna, Austria

[11] Fdn Inst Valenciano Oncol, Gynecol Oncol Dept, Valencia, Spain

[12] Med Univ Gdansk, Dept Surg Oncol, Gdansk, Poland

[13] Hosp Univ Virgen Rocio, Gynecol Oncol Dept, Seville, Spain

[14] Complejo Hosp Univ Santiago De Compostela, Gynecol Dept, Santiago De Compostela, Galicia, Spain

[15] Ciudad Sanitaria Bellvitge, Gynecol Oncol Dept, Barcelona, Spain

[16] Hosp Cruces, Gynecol Oncol Dept, Vizcaya, Spain

[17] Hosp Univ Cent Asturias, Gynecol Dept, Asturias, Spain

[18] Hosp Lithuanian Univ Hlth Sci, Kauno Klinikos, Gynecol Oncol Dept, Kaunas, Lithuania

[19] St Orsola Marcello Malpighi Hosp, Gynecol Dept, Bologna, Italy

[20] Complejo Hosp Leon, Gynecol Dept, Leon, Spain

[21] Complejo Hosp Univ Juan Canalejo, Gynecol Dept, La Coruna, Spain

[22] Alexandra Hosp, Gynecol Oncol, Athens, Greece

[23] Hosp Valle De Hebron, Gynecol Dept, Barcelona, Spain

[24] Maria Sklodowska Curie Mem Canc Ctr, Gynecol Oncol Dept, Krakow, Poland

[25] Complejo Hosp Torrecardenas, Gynecol Dept, Almeria, Spain

[26] Hosp Univ Miguel Servet, Gynecol Dept, Zaragoza, Spain

[27] Fdn IRCCS Policlin San Matteo, Gynecol Oncol Dept, Pavia, Italy

[28] Metaxa Mem Canc Hosp, Gynecol Dept, Athens, Greece

[29] Ege Gynaecol Training & Res Hosp, Gynecol Oncol Dept, Izmir, Turkey

[30] Inst Univ Dexeus, Gynecol Dept, Barcelona, Spain

[31] Riga East Clin Univ Hosp, Latvian Oncol Ctr, Gynecol Oncol Dept, Riga, Latvia

来源：

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER | 2020年 / 30卷 / 09期

关键词：

vulvar and vaginal cancer; vulvar neoplasms; neoplasm recurrence; local; SQUAMOUS-CELL CARCINOMA; RECURRENCE; EPIDEMIOLOGY; SURVIVAL; PATTERNS; NODES;

D O I：

10.1136/ijgc-2019-000526

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective This study aimed to analyze the prognostic factors for overall and progression-free survival in patients with vulvar cancer. Methods This international, multicenter, retrospective study included 2453 patients diagnosed with vulvar cancer at 100 different institutions. Inclusion criteria were institutional review board approval from each collaborating center, pathologic diagnosis of invasive carcinoma of the vulva, and primary treatment performed at the participating center. Patients with intraepithelial neoplasia or primary treatment at non-participating centers were excluded. Global survival analysis and squamous cell histology subanalysis was performed. Results After excluding patients due to incomplete data entry, 1727 patients treated for vulvar cancer between January 2001 and December 2005 were registered for analysis (1535 squamous, 42 melanomas, 38 Paget's disease and 112 other histologic types). Melanomas had the worse prognosis (p=0.02). In squamous vulvar tumors, independent factors for increase in local recurrence of vulvar cancer were: no prior radiotherapy (p<0.001) or chemotherapy (p=0.006), and for distant recurrence were the number of positive inguinal nodes (p=0.025), and not having undergone lymphadenectomy (p=0.03) or radiotherapy (p<0.001), with a HR of 1.1 (95% CI 1.2 to 1.21), 2.9 (95% CI 1.4 to 6.1), and 3.1 (95% CI 1.7 to 5.7), respectively. Number of positive nodes (p=0.008), FIGO stage (p<0.001), adjuvant chemotherapy (p=0.001), tumor resection margins (p=0.045), and stromal invasion >5 mm (p=0.001) were correlated with poor overall survival, and large case volume (>= 9 vs <9 cases per year) correlated with more favorable overall survival (p=0.05). Conclusions Advanced patient age, number of positive inguinal lymph nodes, and lack of adjuvant treatment are significantly associated with a higher risk of relapse in patients with squamous cell vulvar cancer. Case volume per treating institution, FIGO stage, and stromal invasion appear to impact overall survival significantly. Future prospective trials are warranted to establish these prognostic factors for vulvar cancer.

引用

页码：1285 / 1291

页数：7

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