Prognostic factors and a value of 2009 FIGO staging system in vulvar cancer

Sznurkowski, Jacek Jan; Milczek, Tomasz; Emerich, Janusz

doi:10.1007/s00404-012-2683-x

Cited by 27 publications

(25 citation statements)

References 23 publications

(27 reference statements)

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“…Similar findings were published by Blecharz and coworkers, revealing a 5-year overall survival rate of 30.5 % in patients over 70 years of age [21]. The impact of lymph node metastasis on the overall survival as presented by Sznurkowski et al was comparable to our series, with 50 % of all patients dying due to the disease within the first 20 months [22]. In the studies mentioned before, 5-year survival rate after pelvic exenteration was 54, ∼30 and 27,4 %, respectively [6,[16][17][18].…”

Section: Discussionsupporting

confidence: 92%

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

et al. 2015

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Vulva cancer is the fourth leading gynaecological malignancy, accounting for approximately 4 % of all gynaecological cancers. Surgery represents the treatment of choice, and cases of advanced or recurrent vulvar cancers are to date a major challenge to multidisciplinary teams. Abdominoperineal excision (APE) in combination with vulvectomy and inguinal lymphadenectomy is the only curative treatment option. Patients' files of all women with squamous cell carcinoma of the vulva who underwent abdominoperineal resection were retrospectively reviewed with special regards to technical challenges the general surgeon will face. Seven women were enrolled in this retrospective study with a median age of 71 years (range 56-79 years). In six patients, the pelvic floor after abdominoperineal excision could be closed by direct suture of the levator muscles. One woman underwent abdominoperineal resection with closure of the defect using a vertical rectus abdominis myocutaneous (VRAM) flap. All women underwent radical vulvectomy, in five patients in combination with bilateral inguinal lymph node dissection. Operation time was 377 min (range 130-505 min). The median overall survival after surgery was 27 months (range 4-84 months), with a calculated 5-year survival rate of 42 %. Women with negative lymph nodes revealed a longer survival time after surgery compared to women with lymph node metastases (15.5 vs. 72 months; p=0.09). Abdominoperineal excisions represent a powerful tool in the multidisciplinary treatment regimen of advanced or recurrent vulvar cancer. Reconstruction of the pelvic floor usually does not require myocutaneous flaps, even when facing large tumours. Despite high complication rates, radical surgery was a feasible treatment with long-term survival potential without mortality.

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Section: Discussionsupporting

confidence: 92%

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

et al. 2015

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“…The prognostic factors for vulvar cancer have been investigated in several studies [6][7][8]. Tumor invasion deeper than 2 mm was found to be a risk factor for local recur-rence [9].…”

Section: Introductionmentioning

confidence: 99%

The effect of lymph node metastasis on overall survival and disease-free survival in vulvar cancer patients

et al. 2020

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Objectives: To examine the effect of lymphadenectomy on survival in patients with squamous cell vulvar carcinoma. Material and methods: Patients with squamous cell vulvar cancer who underwent surgery were retrospectively analyzed. All procedures were performed according to current recommendations/standard of treatment. The clinical and pathological features were examined. Sixty-eight patients were studied. The mean age was 64.7 ± 10.9 years. Twenty-three (33.8%) patients had nodal metastasis. Most patients (60.3%) were in stage IB. Adjuvant radiotherapy and chemo-radiotherapy were administered to 33.8% and 25% of the patients, respectively. The median follow-up time was 28.5 (4-183) months. Recurrence occurred in 18 (26.5%) cases. Results: There was no significant difference between node-positive and node-negative patients in terms of age, number of dissected lymph nodes and recurrence. Tumor diameter was significantly higher in the metastatic group. Age and surgical margin positivity were independent prognostic factors for overall survival (OS). Surgical margin positivity and lymph node metastasis had no effect on disease-free survival (DFS). Conclusions: Our results showed that age and surgical margin positivity were independent prognostic factors for OS. Although surgical margin positivity increased the risk of recurrence in univariate analysis, it was not a significant factor affecting DFS. OS was significantly lower in patients with lymph node metastasis.

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“…13 From the first staging classification proposed by The League of Nations in 1937 to the more recent FIGO (2015) and American Joint Committee on Cancer (AJCC) Staging Manuel (2010) classifications, APW play no role in the staging of cancers of the uterine cervix. 16,18,19 In contrast to malignancies of the vulva, vagina, and uterine cervix, staging protocols for malignancies of the uterine corpus and ovary have taken into consideration APW cytology, and are currently considered an important factor in distinguishing between different stages of ovarian carcinoma. 16,17 Although some data suggest that histologic grade may play a prognostic role in the staging of vulvar cancer, APW cytology is not a component of staging of vulvar cancer.…”

Section: Historical Aspectsmentioning

confidence: 99%

“…16,17 Although some data suggest that histologic grade may play a prognostic role in the staging of vulvar cancer, APW cytology is not a component of staging of vulvar cancer. 16,18,19 In contrast to malignancies of the vulva, vagina, and uterine cervix, staging protocols for malignancies of the uterine corpus and ovary have taken into consideration APW cytology, and are currently considered an important factor in distinguishing between different stages of ovarian carcinoma. [20][21][22][23] Positive ascites fluid and APW show prognostic significance in ovarian carcinoma, and thus remain a significant part of staging.…”

Section: Historical Aspectsmentioning

confidence: 99%

Abdominopelvic washings in gynecologic pathology: A comprehensive review

Schulte

Lastra

2016

Diagnostic Cytopathology

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Abdominopelvic washings (APW) performed during gynecologic surgeries have become a common specimen evaluated by cytopathologists. Their role in staging of female genital tract tumors has changed significantly since they were first described, and continue to evolve. The ability of these washings to detect microscopic disease, even in the absence of gross disease, warrants the critical role that these washings play in the staging of certain female gynecologic tract tumors, allowing for optimal staging and subsequent treatment of the patient. Irrespective of the underlying pathology, the gamut of cytomorphologic findings that may be observed in APW is extensive, and ranges from benign lesions that may act as mimickers of malignancy, to both common and rare malignancies. This review discusses the changing role of APW in the staging of gynecologic tumors, and highlights the salient cytomorphologic features of these lesions, with emphasis in their correct identification, including cautionary notes to avoid over or misinterpretation. Diagn. Cytopathol. 2016;44:1039-1057. © 2016 Wiley Periodicals, Inc.

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Prognostic factors and a value of 2009 FIGO staging system in vulvar cancer

Cited by 27 publications

References 23 publications

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers—Analysis of a Single-Centre Experience

The effect of lymph node metastasis on overall survival and disease-free survival in vulvar cancer patients

Abdominopelvic washings in gynecologic pathology: A comprehensive review

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