Abstract
Vulvar cancer is a relatively rare disease. The aim of this study was to investigate prognostic factors in vulvar squamous cell carcinoma patients treated with primary surgery. Forty cases of vulvar squamous cell carcinoma treated with primary surgery were retrospectively analyzed. Overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan–Meier method and prognostic factors were analyzed by multivariate analyses. The median age was 68 years. The FIGO stage distribution was as follows: 18 cases (45.0 %) in stage I, four cases (10.0 %) in stage II, 15 cases (37.5 %) in stage III, and three cases (7.5 %) in stage IV. A radical local excision was performed in 15 patients, and radical vulvectomy in 25 patients, and seven of these patients were treated with postoperative RT. The 5-year DSS rate was 72.6 %, and the 5-year OS rate was 70.3 %. Age and surgical margin ≤5 mm were independent prognostic factors for OS, and positive inguinal LN metastasis and surgical margin ≤5 mm were identified as independent prognostic factors for DSS. Complete radical excision is important regardless of operation mode. Adjuvant treatment should be considered for inguinal LN positive patients.
Highlights
Vulvar cancer is a relatively rare disease, representing only 3–5 % of gynecologic malignancies
We retrospectively reviewed the medical records for squamous cell carcinoma of the vulva cases treated with primary surgery in our department, and summarized prognostic factors and failure patterns
A radical local excision was performed in 15 patients, and radical vulvectomy in 25 patients, and seven of these patients were treated with postoperative radiation therapy (RT)
Summary
Vulvar cancer is a relatively rare disease, representing only 3–5 % of gynecologic malignancies. It typically affects older women aged 65–70 years, the incidence among younger women is increasing. Around 90 % of vulvar cancers are squamous cell carcinomas. The standard treatment for early disease consists of radical local excision of the primary tumor with sentinel lymph node (LN) biopsy and/or inguinal lymphadenectomy. Advanced disease is often managed with a combination of radiation therapy (RT) and/or chemotherapy (Hacker 2005; Beller et al 2006; Joura 2002). The appropriate treatment in each case should be selected by taking into account the age of the patient, tumor location, performance status (PS), and various complications
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