Predictive factors for lymph node metastases in vulvar cancer. An analysis of the AGO-CaRE-1 multicenter study

被引:18
作者
Klapdor, Ruediger [1 ]
Woelber, Linn [2 ]
Hanker, Lars [3 ]
Schmalfeldt, Barbara [2 ]
Canzler, Ulrich [4 ]
Fehm, Tanja [5 ,6 ]
Luyten, Alexander [7 ]
Hellriegel, Martin [8 ]
Kosse, Jens [9 ]
Heiss, Christoph [10 ]
Hantschmann, Peer [11 ]
Mallmann, Peter [12 ]
Tanner, Berno [13 ]
Pfisterer, Jacobus [14 ]
Jueckstock, Julia [15 ]
Hilpert, Felix [16 ]
de Gregorio, Nikolaus [17 ]
Hillemanns, Peter [1 ]
Fuerst, Sophie Teresa [15 ]
Mahner, Sven [15 ]
机构
[1] Hannover Med Sch, Dept Gynecol, Hannover, Germany
[2] Univ Med Ctr Hamburg Eppendorf, Dept Gynecol, Hamburg, Germany
[3] Dept Gynecol, UKSH Campus Lubeck, Lubeck, Germany
[4] Carl Gustav Carus Univ Dresden, Dept Gynecol & Obstet, TU Dresden, Dresden, Germany
[5] Duesseldorf Univ Hosp, Dept Gynecol, Dusseldorf, Germany
[6] Univ Tubingen, Dept Gynecol & Obstet, Tubingen, Germany
[7] Klinikum Wolfsburg, Dept Obstet & Gynecol, Wolfsburg, Germany
[8] Georg August Univ, Dept Gynecol & Obstet, Gottingen, Germany
[9] Sana Klinikum Offenbach, Dept Gynaecol, Offenbach, Germany
[10] Alb Fils Kliniken, Klin Eichert, Dept Gynecol, Goppingen, Germany
[11] Hosp Altoettingen, Dept Gynecol, Altoettignen, Germany
[12] Univ Hosp Cologne, Dept Gynecol, Cologne, Germany
[13] Oberhavel Hosp, Oranienburg, Germany
[14] Gynecol Oncol Ctr, Kiel, Germany
[15] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Obstet & Gynecol, Munich, Germany
[16] Jerusalem Hosp, Hamburg, Germany
[17] Univ Ulm, Dept Gynecol, Ulm, Germany
关键词
Vulvar cancer; Lymph node metastases; Sentinel lymph node; Predictive factors; SQUAMOUS-CELL CARCINOMA; PROGNOSTIC-FACTORS; DISSECTION; RECURRENCE; SURVIVAL; PATTERNS;
D O I
10.1016/j.ygyno.2019.06.013
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Lymph node (LN) metastasis is the most important prognostic factor in primary vulvar cancer. Assessing risk factors for the incidence and extent of LN metastases may help to select the optimal treatment strategy for each individual patient. Methods. In a subgroup analysis of the large multicenter AGO-CaRE-1 study we included all patients treated with radical groin dissection. Univariate and multivariate regression analyses were performed in order to detect factors associated with the prevalence and extent of nodal involvement. Results. In total, 1162 patients were analyzed. Univariate analyses detected age, ECOG as well as multiple tumor characteristics such as FIGO stage, grading, depth of invasion, tumor diameter, and (lymph)vascular space invasion to be related with the prevalence of LN metastases. Interestingly, only tumor stage, tumor diameter and depth of infiltration were found to be significantly associated with the number of LN metastases. In multivariate analysis, age (OR 1.03), lymphvascular space invasion (OR 4.97), tumor stage (OR 2.22) and depth of infiltration (OR 1.08) showed an association with the prevalence of LN metastases. Regarding the number of metastatic LNs, only tumor stage (OR 221) or, if excluded, tumor diameter (OR 1.02) were tested significant. Conclusion. This large analysis of the multicenter AGO-CaRE-1-study identified lymphvascular space invasion, tumor stage, and depth of infiltration as factors with the strongest association regarding the prevalence of LN metastasis. Interestingly, tumor stage or, if excluded, tumor diameter were the only factors associated with the prevalence as well as the extent of LN metastases. (C) 2019 Elsevier Inc. All rights reserved.
引用
收藏
页码:565 / 570
页数:6
相关论文
共 20 条
[1]   THE IMPORTANCE OF THE GROIN NODE STATUS FOR THE SURVIVAL OF T1 AND T2 VULVAR CARCINOMA PATIENTS [J].
BURGER, MPM ;
HOLLEMA, H ;
EMANUELS, AG ;
KRANS, M ;
PRAS, E ;
BOUMA, J .
GYNECOLOGIC ONCOLOGY, 1995, 57 (03) :327-334
[2]   Sentinel lymph node procedure is highly accurate in squamous cell carcinoma of the vulva [J].
de Hullu, JA ;
Hollema, H ;
Piers, DA ;
Verheijen, RHM ;
van Diest, PJ ;
Mourits, MJE ;
Aalders, JG ;
van der Zee, AGJ .
JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (15) :2811-2816
[3]   Clinico-pathological and biological prognostic variables in squamous cell carcinoma of the vulva [J].
Gadducci, Angiolo ;
Tana, Roberta ;
Barsotti, Cecilia ;
Guerrieri, Maria Elena ;
Genazzani, Andrea Riccardo .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2012, 83 (01) :71-83
[4]   ASSESSMENT OF CURRENT INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS STAGING OF VULVAR CARCINOMA RELATIVE TO PROGNOSTIC FACTORS FOR SURVIVAL (A GYNECOLOGIC ONCOLOGY GROUP-STUDY) [J].
HOMESLEY, HD ;
BUNDY, BN ;
SEDLIS, A ;
YORDAN, E ;
BEREK, JS ;
JAHSHAN, A ;
MORTEL, R .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1991, 164 (04) :997-1004
[5]   PROGNOSTIC FACTORS FOR GROIN NODE METASTASIS IN SQUAMOUS-CELL CARCINOMA OF THE VULVA (A GYNECOLOGIC-ONCOLOGY-GROUP-STUDY) [J].
HOMESLEY, HD ;
BUNDY, BN ;
SEDLIS, A ;
YORDAN, E ;
BEREK, JS ;
JAHSHAN, A ;
MORTEL, R .
GYNECOLOGIC ONCOLOGY, 1993, 49 (03) :279-283
[6]   Outcome After Sentinel Lymph Node Dissection in Vulvar Cancer: A Subgroup Analysis of the AGO-CaRE-1 Study [J].
Klapdor, Ruediger ;
Hillemanns, Peter ;
Woelber, Linn ;
Jueckstock, Julia ;
Hilpert, Felix ;
de Gregorio, Nikolaus ;
Iborra, Severine ;
Sehouli, Jalid ;
Habermann, Anika ;
Fuerst, Sophie Teresa ;
Strauss, Hans Georg ;
Baumann, Klaus ;
Thiel, Falk ;
Mustea, Alexander ;
Meier, Werner ;
Harter, Philipp ;
Wimberger, Pauline ;
Hanker, Lars ;
Schmalfeldt, Barbara ;
Canzler, Ulrich ;
Fehm, Tanja ;
Luyten, Alexander ;
Hellriegel, Martin ;
Kosse, Jens ;
Heiss, Christoph ;
Hantschmann, Peer ;
Mallmann, Peter ;
Tanner, Berno ;
Pfisterer, Jacobus ;
Richter, Barbara ;
Jager, Martin ;
Mahner, Sven .
ANNALS OF SURGICAL ONCOLOGY, 2017, 24 (05) :1314-1321
[7]   Groin Recurrences in Node Negative Vulvar Cancer Patients After Sole Sentinel Lymph Node Dissection [J].
Klapdor, Ruediger ;
Hertel, Hermann ;
Soergel, Philipp ;
Hillemanns, Peter .
INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 2017, 27 (01) :166-170
[8]   Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study [J].
Levenback, Charles F. ;
Ali, Shamshad ;
Coleman, Robert L. ;
Gold, Michael A. ;
Fowler, Jeffrey M. ;
Judson, Patricia L. ;
Bell, Maria C. ;
De Geest, Koen ;
Spirtos, Nick M. ;
Potkul, Ronald K. ;
Leitao, Mario M., Jr. ;
Bakkum-Gamez, Jamie N. ;
Rossi, Emma C. ;
Lentz, Samuel S. ;
Burke, James J., II ;
Van Le, Linda ;
Trimble, Cornelia L. .
JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (31) :3786-3791
[9]  
Maggino T, 2000, CANCER-AM CANCER SOC, V89, P116, DOI 10.1002/1097-0142(20000701)89:1<116::AID-CNCR16>3.0.CO
[10]  
2-4