TY - JOUR
T1 - Patterns of recurrence in patients with squamous cell carcinoma of the vulva
T2 - A multicenter CTF study
AU - Maggino, Tiziano
AU - Landoni, Fabio
AU - Sartori, Enrico
AU - Zola, Paolo
AU - Gadducci, Angiolo
AU - Alessi, Chiara
AU - Soldà, Marika
AU - Coscio, Stefania
AU - Spinetti, Giovanna
AU - Maneo, Andrea
AU - Ferrero, Annamaria
AU - De Toffoli, Giuseppe Konishi
PY - 2000/7/1
Y1 - 2000/7/1
N2 - BACKGROUND. Invasive vulvar carcinoma is a rare disease with an incidence rate of 3-5% of all female genital neoplasms. The current study discusses the limited number of articles in the literature regarding the patterns of recurrence as well as the clinical outcome of patients with recurrent disease based on a consistent and consecutive series of cases. METHODS. A common clinical chart focusing on the study of patterns of recurrence was used in five Italian gynecologic institutions with uniform criteria of surgical nomenclature, pathologic variables, and sites of recurrence. Between 1980-1994, 502 cases of primary invasive squamous carcinoma of the vulva were registered consecutively, treated, and considered for this multicentered study. RESULTS. Of 502 patients, 187 (37.3%) developed a recurrence. Distribution of the recurrences by site was as follows: perineal, 53.4%; inguinal, 18.7%; pelvic, 5.7%; distant, 7.9%; and multiple, 14.2%. In a multivariate analysis, 3 characteristics appeared to be statistically correlated with the risk of recurrence: International Federation of Gynecology and Obstetrics Stage > II (P = 0.029), positive lymph nodes (P = 0.009), and vascular space invasion (P = 0.004). The 5-year survival rate was 60% for perineal recurrences, 27% for inguinal and pelvic recurrences, 15% for distant recurrences, and 14% for multiple recurrences. CONCLUSIONS. In the current study the prognostic factors found to have statistical significance as prognostic factors for risk of recurrence were tumor dimension lymph node involvement, and stromal and vascular space invasion. The presence of inguinal lymph node metastases was predictive of multiple and distant recurrences with a low rate of incidence of isolated perineal recurrence (27%) compared with negative lymph node cases (57.5%). Survival analysis of recurrent disease showed that the surgical resection of local recurrences may provide acceptable results (51% at 5 years). This observation may justify a follow-up program aimed at identifying those patients with early local recurrence suitable for radical resection. (C) 2000 American Cancer Society.
AB - BACKGROUND. Invasive vulvar carcinoma is a rare disease with an incidence rate of 3-5% of all female genital neoplasms. The current study discusses the limited number of articles in the literature regarding the patterns of recurrence as well as the clinical outcome of patients with recurrent disease based on a consistent and consecutive series of cases. METHODS. A common clinical chart focusing on the study of patterns of recurrence was used in five Italian gynecologic institutions with uniform criteria of surgical nomenclature, pathologic variables, and sites of recurrence. Between 1980-1994, 502 cases of primary invasive squamous carcinoma of the vulva were registered consecutively, treated, and considered for this multicentered study. RESULTS. Of 502 patients, 187 (37.3%) developed a recurrence. Distribution of the recurrences by site was as follows: perineal, 53.4%; inguinal, 18.7%; pelvic, 5.7%; distant, 7.9%; and multiple, 14.2%. In a multivariate analysis, 3 characteristics appeared to be statistically correlated with the risk of recurrence: International Federation of Gynecology and Obstetrics Stage > II (P = 0.029), positive lymph nodes (P = 0.009), and vascular space invasion (P = 0.004). The 5-year survival rate was 60% for perineal recurrences, 27% for inguinal and pelvic recurrences, 15% for distant recurrences, and 14% for multiple recurrences. CONCLUSIONS. In the current study the prognostic factors found to have statistical significance as prognostic factors for risk of recurrence were tumor dimension lymph node involvement, and stromal and vascular space invasion. The presence of inguinal lymph node metastases was predictive of multiple and distant recurrences with a low rate of incidence of isolated perineal recurrence (27%) compared with negative lymph node cases (57.5%). Survival analysis of recurrent disease showed that the surgical resection of local recurrences may provide acceptable results (51% at 5 years). This observation may justify a follow-up program aimed at identifying those patients with early local recurrence suitable for radical resection. (C) 2000 American Cancer Society.
KW - Prognostic factors
KW - Recurrence
KW - Surgical treatment
KW - Vulvar carcinoma
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U2 - 10.1002/1097-0142(20000701)89:1<116::AID-CNCR16>3.0.CO;2-4
DO - 10.1002/1097-0142(20000701)89:1<116::AID-CNCR16>3.0.CO;2-4
M3 - Article
C2 - 10897008
AN - SCOPUS:0034234628
VL - 89
SP - 116
EP - 122
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 1
ER -