Prognostic factors and surgical treatment in vulvar carcinoma: Single center experience

Abstract

Aim Vulvar carcinoma represents 3–5% of all female genital cancers; the main surgical treatment is radical vulvectomy and inguinal lymphadenectomy. The aim of this study is to analyze prognostic factors in the patients underwent to primary surgery for vulvar carcinoma. Methods One hundred and eighteen cases of vulvar carcinoma underwent surgery between 2006 and 2016 at Operative Unit of Gynecology and Obstetrics of Cannizzaro Hospital (Catania, Italy) were retrospective analyzed. Risk factors for relapse (age, tumor size, FIGO stage, type of surgery, lymphadenectomy, margins status, metastatic nodes and radiotherapy) were evaluated by logistic regression. Univariate analysis of prognostic factors (age, tumor size, FIGO stage, metastatic inguinal nodes and type of surgery) was obtained by Cox proportional hazard model. Overall survival was calculated by Kaplan–Meier curves either for the entire population and for comparison between positive and negative variables (margin status, nodes and radiotherapy) with log‐rank test to determine significance. Statistical significance was reached for P < 0.05. Results Type of surgery (radical local excision vs. radical vulvectomy) and positive inguinal nodes were identified as risk factors for relapse. Positive inguinal nodes and positive margins were identified as prognostic factors either for overall survival and disease specific survival; tumor size greater than 4 cm was identified as prognostic factors for overall survival. Overall survival was 38.4% and it was significantly higher in the patients with negative margins and nodes. Conclusions Nodes status, resection margins, age and type of surgery represent prognostic factors have to be considered for adjuvant treatment in the patients affected from vulvar carcinoma.

ABT‑737 increases cisplatin sensitivity through the ROS‑ASK1‑JNK MAPK signaling axis in human ovarian cancer cisplatin‑resistant A2780/DDP cells

“…Cellular experiments do not fully reflect the role of ABT-737 in vivo . To address this in an improved way, as well as the effects on the ROS-ASK1-JNK signaling pathway ( 47 ), animal experiments should be conducted in the future to explore the impact of ABT-737 on cisplatin sensitivity in living animals.…”

Management of Vulvar Cancer Our Clinical Experiences

“…This finding obtained in our study was confirmed by a similar study. In the study mentioned above, positive inguinal nodes were defined as a prognostic factor for both overall survival and disease-specific survival, and tumor size as a prognostic factor for overall survival [18].…”

Indocyanine green fluorescence imaging, sentinel lymph node mapping in patients with vulvar cancer: peritumoral injection dosage and waiting times in our experience

“…Intraoperative detection of sentinel lymph node (SLN) in vulvar squamous cell carcinoma (vSCC) by peritumor administration of indocyanine green (ICG) and near-infrared fluorescence (NIRF) camera has numerous advantages. This procedure replaced the standard procedure for administering a radioactive tracer, which, according to The European Society of Gynaecological Oncology (ESGO) guidelines, has been mandatory and could prevent patients with early-stage vulvar cancer from experiencing peritumoral injection associated discomfort before surgery [18]. Additionally, the superficial localization of most inguinal lymph nodes may allow for transcutaneous lymphatic mapping in the groin.…”

“…Patients with tumors located more than 1 cm from the midline were treated with ipsilateral inguinal lymphadenectomy, frozen section, and possible contralateral lymphadenectomy. Inguinal lymphadenectomy was not performed in patients with early-stage tumors (FIGO stage IA with stromal invasion <1 mm) and in very elderly patients (≥80 years) with multiple comorbidities [18].…”