Abstract
Objective This study analyzed the prognostic significance of nodal involvement in vulvar squamous carcinoma and its correlation with other prognostic factors, focusing the research on comparison between <75 and 75 years old patients. Methods We prospectively enrolled patients with > 1-mm-deep stromal invasion, Ib-III stage vulvar cancer. Patients underwent unilateral or bilateral inguinal lymphadenectomy, according to tumor localization. Results In total, 131 patients met inclusion criteria; 93 (71%) underwent bilateral and 38 (29%) unilateral lymphadenectomy with 36 (27%) of them presenting nodal disease. At Kaplan-Meier analysis factors associated to prognosis were nodal status (in very elderly patients also) and number of resected nodes both in bilateral and unilateral lymphadenectomy groups. In univariate analysis, covariates associated with survival included age, in terms of overall survival (OS) but not with disease free-survival (DFS) and disease-specific survival (DSS), grading, nodal status, the presence of bilateral nodal metastases, the number of resected nodes in both unilateral, in terms of OS and DSS but not of DFS and bilateral lymphadenectomy and the number of metastatic nodes. In multivariate analysis covariates associated with survival were age, the number of positive nodes and the number of resected nodes in bilateral lymphadenectomy. Conclusions Results confirm the prognostic role of nodal status in very elderly patients also. Although DSS in older patients resulted worse, lymphadenectomy is not associated with more complications, suggesting its importance in older patients too. Furthermore, the resection of less than 15 lymph nodes in bilateral lymphadenectomy seems to have a negative impact on survival.
| Original language | English |
|---|---|
| Pages (from-to) | 373-379 |
| Number of pages | 7 |
| Journal | Gynecologic Oncology |
| Volume | 137 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 1 2015 |
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Keywords
- Lymphadenectomy
- Nodal status
- Prognosis
- Squamous vulvar cancer
- Survival
- Very elderly patients
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Oncology
- Medicine(all)
Cite this
Prognostic role of inguinal lymphadenectomy in vulvar squamous carcinoma : Younger and older patients should be equally treated. A prospective study and literature review. / Panici, Pierluigi Benedetti; Tomao, Federica; Domenici, Lavinia; Giannini, Andrea; Giannarelli, Diana; Palaia, Innocenza; Di Donato, Violante; Musella, Angela; Angioli, Roberto; Muzii, Ludovico.
In: Gynecologic Oncology, Vol. 137, No. 3, 01.06.2015, p. 373-379.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic role of inguinal lymphadenectomy in vulvar squamous carcinoma
T2 - Younger and older patients should be equally treated. A prospective study and literature review
AU - Panici, Pierluigi Benedetti
AU - Tomao, Federica
AU - Domenici, Lavinia
AU - Giannini, Andrea
AU - Giannarelli, Diana
AU - Palaia, Innocenza
AU - Di Donato, Violante
AU - Musella, Angela
AU - Angioli, Roberto
AU - Muzii, Ludovico
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Objective This study analyzed the prognostic significance of nodal involvement in vulvar squamous carcinoma and its correlation with other prognostic factors, focusing the research on comparison between <75 and 75 years old patients. Methods We prospectively enrolled patients with > 1-mm-deep stromal invasion, Ib-III stage vulvar cancer. Patients underwent unilateral or bilateral inguinal lymphadenectomy, according to tumor localization. Results In total, 131 patients met inclusion criteria; 93 (71%) underwent bilateral and 38 (29%) unilateral lymphadenectomy with 36 (27%) of them presenting nodal disease. At Kaplan-Meier analysis factors associated to prognosis were nodal status (in very elderly patients also) and number of resected nodes both in bilateral and unilateral lymphadenectomy groups. In univariate analysis, covariates associated with survival included age, in terms of overall survival (OS) but not with disease free-survival (DFS) and disease-specific survival (DSS), grading, nodal status, the presence of bilateral nodal metastases, the number of resected nodes in both unilateral, in terms of OS and DSS but not of DFS and bilateral lymphadenectomy and the number of metastatic nodes. In multivariate analysis covariates associated with survival were age, the number of positive nodes and the number of resected nodes in bilateral lymphadenectomy. Conclusions Results confirm the prognostic role of nodal status in very elderly patients also. Although DSS in older patients resulted worse, lymphadenectomy is not associated with more complications, suggesting its importance in older patients too. Furthermore, the resection of less than 15 lymph nodes in bilateral lymphadenectomy seems to have a negative impact on survival.
AB - Objective This study analyzed the prognostic significance of nodal involvement in vulvar squamous carcinoma and its correlation with other prognostic factors, focusing the research on comparison between <75 and 75 years old patients. Methods We prospectively enrolled patients with > 1-mm-deep stromal invasion, Ib-III stage vulvar cancer. Patients underwent unilateral or bilateral inguinal lymphadenectomy, according to tumor localization. Results In total, 131 patients met inclusion criteria; 93 (71%) underwent bilateral and 38 (29%) unilateral lymphadenectomy with 36 (27%) of them presenting nodal disease. At Kaplan-Meier analysis factors associated to prognosis were nodal status (in very elderly patients also) and number of resected nodes both in bilateral and unilateral lymphadenectomy groups. In univariate analysis, covariates associated with survival included age, in terms of overall survival (OS) but not with disease free-survival (DFS) and disease-specific survival (DSS), grading, nodal status, the presence of bilateral nodal metastases, the number of resected nodes in both unilateral, in terms of OS and DSS but not of DFS and bilateral lymphadenectomy and the number of metastatic nodes. In multivariate analysis covariates associated with survival were age, the number of positive nodes and the number of resected nodes in bilateral lymphadenectomy. Conclusions Results confirm the prognostic role of nodal status in very elderly patients also. Although DSS in older patients resulted worse, lymphadenectomy is not associated with more complications, suggesting its importance in older patients too. Furthermore, the resection of less than 15 lymph nodes in bilateral lymphadenectomy seems to have a negative impact on survival.
KW - Lymphadenectomy
KW - Nodal status
KW - Prognosis
KW - Squamous vulvar cancer
KW - Survival
KW - Very elderly patients
UR - http://www.scopus.com/inward/record.url?scp=84930039871&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930039871&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2015.03.013
DO - 10.1016/j.ygyno.2015.03.013
M3 - Article
C2 - 25887098
AN - SCOPUS:84930039871
VL - 137
SP - 373
EP - 379
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -