Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (A Gynecologic Oncology Group Study)

Homesley, Howard D.; Bundy, Brian N.; Sedlis, Alexander; Yordan, Edgardo; Berek, Jonathan S.; Jahshan, Antoine E.; Mortel, Rodrique

doi:10.1016/0002-9378(91)90573-a

Cited by 330 publications

(158 citation statements)

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“…The most important prognostic factor in patients with vulvar cancer is the inguinofemoral lymph node status [1]. Until recently inguinofemoral lymphadenectomy was the only possibility to be adequately informed on the lymph node status.…”

Section: Introductionmentioning

confidence: 99%

“…Until recently inguinofemoral lymphadenectomy was the only possibility to be adequately informed on the lymph node status. However, the morbidity of this procedure is high, while only 25-35% of early stage vulvar cancer patients will have lymph node metastases and thereby benefit from this surgery [1,2]. In the other 65-75% this intervention will (in retrospect) probably be only diagnostic.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Oonk

Bock

et al. 2009

Gynecologic Oncology

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A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy Oonk, M. H. M.; van Os, M. A.; de Bock, G. H.; de Hullu, J. A.; Ansink, A. C.; van der Zee, A. G. J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Objectives. The SLN-procedure has been introduced in vulvar cancer treatment to reduce morbidity and thereby improve quality of life. Aim of this study was to compare quality of life in vulvar cancer patients who were treated with a SLN-procedure only to those who underwent inguinofemoral lymphadenectomy. Moreover, it was evaluated what patients would advise relatives on the application of the SLN-procedure in light of possible false negative results.Methods. Patients who participated in the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) were invited to fill out three questionnaires: the EORTC QLQ-C30, a vulvar specific questionnaire and a questionnaire about the opinion of patients on new treatment options. Patients who only underwent SLN-procedure were compared to those who subsequently underwent inguinofemoral lymphadenectomy because of a positive SLN.Results. With a response rate of 85%, 35 patients after the SLN-procedure and 27 patients after inguinofemoral lymphadenectomy filled out the questionnaires. No difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of lymphedema of the legs after inguinofemoral lymphadenectomy. The majority of patients would advise the SLN-procedure to relatives. Patients after inguinofemoral lymphadenectomy were more reserved concerning the acceptable false negative rate of a new diagnostic procedure.Conclusions. Patients who underwent the SLN-procedure report less treatment related morbidity compared to those who underwent inguinofemoral lymphadenectomy. However, this did not influence overall quality of life. Furthermore, patients who underwent inguinofemoral lymphadenectomy are more reserved in advising the SLN-procedure to relatives.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Oonk

Bock

et al. 2009

Gynecologic Oncology

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“…These advances were enabled by better understanding of the prognosis or course of the disease. [8][9][10][11] The conventional prognostic tool is FIGO staging system. 12 This system is based on tumor size, lymph node status, and presence of distant metastasis.…”

Section: Discussionmentioning

confidence: 99%

Validation of a nomogram for predicting outcome of vulvar cancer patients, primarily treated by surgery, in Korean population: multicenter retrospective study through Korean Gynecologic Oncology Group (KGOG-1010)

Kim

Lee

et al. 2008

J Gynecol Oncol

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Objective: Regarding vulvar cancer, a nomogram has been suggested for the prediction of relapse-free survival (RFS). While the nomogram has been developed and validated in a Western study, there was no validation in Korean population. Thus, we have undertaken the study to assess the applicability of nomogram for predicting RFS in Korean patients with vulvar cancer. Methods: A total of 204 cases newly diagnosed as vulvar cancer between 1982 and 2006 were identified. Among them 70 cases were not eligible due to inappropriate cell type (40 cases) and radiation as primary therapy (30 cases). Fortyfour cases were not evaluable due to inadequate data and persistent disease. Finally a total of 90 patients primarily treated by surgery were included for analysis. Variables including age and the characteristics of primary tumor, nodal status, and surgical margin were collected for predicting RFS based on nomogram, which was compared with actual RFS. A calibration plot was drawn showing the actual versus predicted probability for 6 groups of patients segregated according to their predicted probabilities. In addition, discrimination of the nomogram was quantified with the concordance index. Results: Patients' mean age was 58 years and mean follow-up period was 47.9 months. Observed 2y-and 5y-RFS rates were 81% and 68%, respectively, corresponding to 79% and 72% in the original cohort. The trend line in calibration plot showed comparable concordance with an ideal line, having a slope of 1.04 for 2y-RFS (R 2 =.35) and 0.98 for 5y-RFS (R 2 =.80), respectively. The concordance index was 0.79 in the KGOG data set, which was improved to 0.82 with the data set limited to squamous cell carcinoma. Conclusion:The nomogram provides the predictive capacity for relapse-free survival in Korean patients with vulvar cancer.

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“…[1][2][3] Since two decades, involvement of groin lymph nodes (LNs) has been reported as the most important prognostic factor for survival. 4 The age, tumor size, tumor location, stage, depth of invasion, the LN status and free margins were suggested as the possible predictive factors of recurrence.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

Cırık¹

2016

UHOD

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We aimed to determine the prognostic significance of tumor and lymph node (LN) characteristics on disease free survival (DFS) in patients who underwent surgery for squamous cell vulvar carcinoma. A total of 94 patients who underwent vulvar surgery and groin dissection were included. The impact of clinicopathologic variables such as age, body mass index, tumor size, tumor depth, total and metastatic lymph node number on DFS were assessed. The estimates of survival were determined with Kaplan-Meier and log rank analysis. In the univariate analysis; age, body mass index, tumor size, tumor location, total LN number, metastatic LN number and adjuvant therapy did not have impact on DFS. The median number of removed LNs was 21. Although removal of higher number of lymph nodes did not improved the DFS, patients who had ≤ 3 metastatic LNs had better 2-year DFS rate compared to those with >3 metastatic LNs (71.8% vs 40.0%; p= 0.042, respectively). In the multivariate analysis, both the depth of tumor invasion and LN involvement were the independent predictors of DFS. Additionally, in stage III disease, patients receiving adjuvant therapy had significantly less locoregional recurrence compared to those who did not receive. The presence of LN metastasis and increased tumor depth (> 3 mm) are poor prognostic factors for DFS in squamous cell vulvar cancer. Although the number of lymph nodes removed was not correlated with DFS, patients who had ≤ 3 metastatic LNs had better DFS compared to those with > 3 LNs. Keywords: Vulvar cancer, lymph node, disease free survival, recurrence ÖZET Skuamöz Hücreli Vulva Kanserinde Tümör ve Lenf Nodu Özelliklerinin Hastalıksız Sağkalıma EtkisiBu çalışmada, skuamöz hücreli vulva kanseri için cerrahi yapılan hastalarda tümör ve lenf nodu (LN) özelliklerinin hastalıksız sağkalıma (DFS) etkisini incelemek amaçlandı. Vulvar cerrahi ve lenf nodu diseksiyonu yapılan toplam 94 hasta çalışmaya dahil edildi. Yaş, vücut kitle indeksi, tümör boyutu, tümör derinliği, total ve metastatik LN sayısı gibi klinikopatolojik değişkenlerin DFS'ye etkisi araştırıldı.Sağkalım analizleri ise Kaplan-Meier ve log rank analizi ile yapıldı. Univaryant analizine göre, yaş, vücut kitle indeksi, tümör boyutu ve yeri, toplam LN sayısı, metastatik LN sayısı ve adjuvan tedavi DFS üzerine etkili bulunmadı. Ortalama olarak 21 tane LN çıkarıldı. Ortalamadan fazla lenf nodu çıkarılması DFS üzerine etkili olmasa da, 3 ve daha az metastatik LN çıkarılan hastalar, 3'den fazla metastatik LN çıkarılanlardan daha iyi 2-yıllık-DFS'ye sahip bulundu (sırasıyla, %71.8 ve %40.0; p= 0.042). Multivaryant analizde, hem tümör derinliği hem de LN tutulumu DFS'nin bağımsız prediktörleri idi. Ek olarak, evre III hastalıkta, adjuvan tedavi alan hastalar almayanlara göre daha az lokal (perineal ve kasık) nüksüne sahip idi. Lenf nodu metastazı ve artmış tümör derinliği (> 3 mm), skuamöz hücreli vulva kanseri için kötü prognostic faktörlerdir. Çıkarılan LN sayısı ile 2-yıllık-DFS korele olmasa da evre III hastalarda, 3 ve daha az metastatik LN...

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Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (A Gynecologic Oncology Group Study)

Cited by 330 publications

References 4 publications

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

A comparison of quality of life between vulvar cancer patients after sentinel lymph node procedure only and inguinofemoral lymphadenectomy

Validation of a nomogram for predicting outcome of vulvar cancer patients, primarily treated by surgery, in Korean population: multicenter retrospective study through Korean Gynecologic Oncology Group (KGOG-1010)

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

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