Gynecologic Oncology Group risk groups for vulvar carcinoma: improvement in survival in the modern era.
Gynecol Oncol
; 106(3): 521-5, 2007 Sep.
Article
em En
| MEDLINE
| ID: mdl-17540438
ABSTRACT
OBJECTIVE:
Patients with vulvar cancer were stratified into risk groups for survival based on surgicopathologic findings from a prospective study conducted by the Gynecologic Oncology Group from 1977-1984. The purpose of this study is to reassess these risk groups in patients treated in an era of contemporary management.METHODS:
Patients with vulvar carcinoma were identified from 1990-2005 for retrospective analysis. Charts were abstracted for clinical, histopathologic and surgical data, and patients stratified into four risk groups for survival based on the clinical size of tumor and extent of lymph node metastasis. Univariate and multivariate characteristics were evaluated and 5-year survival determined by Kaplan-Meier method.RESULTS:
175 patients were identified that underwent surgical management with a median age at diagnosis of 59.9 years. Stage distribution included I (n=89, 51%), II (n=53, 30%), III (n=29, 17%), and IV (n=4, 2%). Stratification into risk groups included minimal (n=89, 51%), low (n=69, 40%), intermediate (n=11, 6%), and high (n=6; 3%). The survival rate was 100%, 97%, 82% and 100%, respectively, at median follow-up of 54.5 months. Comparatively, the survival rates for historic groups were 97.9%, 87.4%, 74.8% and 29.0%. Using multivariate analysis, age (p=0.04) and lymph node metastasis (p=0.009) were predictive of survival.CONCLUSIONS:
Survival among the minimal and low risk groups is preserved in spite of less radical surgery. 5-year survival rate for intermediate and high risk patients also appears to be improved. This is likely a result of advancement in adjuvant chemo-radiation and a younger patient population that presents with less advanced disease.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Vulvares
/
Carcinoma de Células Escamosas
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos