Survival rate and prognostic factors for patients who underwent surgical procedures for invasive carcinoma of the vulva in Serbia

Objectives: To determine five-year survival rate and prognostic factors for patients who underwent radical surgery for carcinoma of the vulva. Material and method: 94 women were operated on from 1989 to 1996 at the Clinical Centre of Serbia. Results: Five-year survival was 78.56% for Stage I, 73.5% for Stage II, for Stage III--14.28%, and for Stage IV--7.14%. Five-year survival rate for tumor size between 2 cm and 5 cm was 57.14%, and for tumors larger than 5 cm, 28.57%. Five-year survival rate was 64.28% if no lymph nodes were involved, 21.43% if there were unilateral metastatic lymph nodes and 14.28% if bilateral lymph nodes had metastatic disease. Histologic grades of the tumor showed that for grade 1, five-year survival was 64.28%, for grade 2, 35.71% and there were no survivors five years after surgery among patients with grade 3 tumor. Conclusion: FIGO stage, size of tumor, lymph node involvement and grade of tumor are significant prognostic factors for survival of patients after surgery.

Carcinoma of the vulva; Prognostic factors; Five-year survival rate

[1] Trope C.G., Makar A. Ph.: "Epidemiology, etiology, screening, prevention and diagnosis in female genital cancer. Review". Curr. Opin. Oncol., 1991, 3, 908.

[2] Thomas G.M., Dembo A.J., Bryson S.C. et al.: "Changing concepts in the management of vulvar cancer". Gynecol. Oncol., 1991, 42, 9.

[3] Cavanagh D., Fiorica J.V., Hoffman M.S. et al.: "Invasive carcinoma of vulva. Changing trends in surgical management". Am. J. Obstet. Gynecol., 1990, 163, 1007.

[4] Bassett T.: "Traitement chirugical operatoire de l'epithelioma primitif du clitoris". Rev. Chir., 1912, 46, 546.

[5] Taussig F.J.: "Cancer of the vulva: an analysis of 155 cases 1911-40". Am. J. Obstet. Gynecol., 1949, 40, 764.

[6] Way S.: "Carcinoma of the vulva". Am. J. Obstet. Gynecol., 1960, 79,692.

[7] Morgan M.K. & Mikuta J.J.: "Surgical management of vulvar cancer". Sem. Surg. Oncol., 1999, 17, 168.

[8] Green M.S., Naumann R.W., Elliot M. et al.: "Sexual dysfunction following vulvectomy". Gynecol. Oncol., 2000, 77, 73.

[9] Van der Velden K.: "Some Aspects of the management of squamous cell carcinoma of the vulva". Ph.D. Thesis. Utrecht, Netherlands, University of Utrecht, 1996.

[10] Creasman W.T.: "New gynecologic cancer staging (editorial)". Gynecol. Oncol., 1995, 58, 157.

[11] Homesley H.D., Bundy B.N., Sedlis A. et al.: "Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (a Gynecologic Oncology Group study)". Am. J. Obstet. Gynecol., 1991, 164, 997.

[12] American Joint Committee on Cancer. AJCC Cancer-Staging Manual, 5th edition, Philadelphia: Lippincott-Raven, 1997, 181.

[13] Hacker N.F., Berek J.S., Lagasse L.K. et al.: "Management of regional lymph nodes and their prognostic influence in vulvar cancer". Obstet. Gynecol., 1983, 61, 408.

[14] Hacker N.F.: "Surgery for gynecologic cancer: results since the introduction of radical operations". Aust. N. Z. J. Obstet. Gynecol., 1990, 30, 24.

[15] Van der Velden J., van Lindert A.C.M., Lammers F.B. et al.: "Extracapsular growth of lymph node metastases in squamous cell carcinoma of the vulva. The impact on recurrence and survival". Cancer, 1995, 75, 2885.

[16] Paladini D., Cross P., Path M.C.C. et al.: "Prognostic significance of lymph node variable in squamous cell carcinoma of the vulva". Cancer, 1994, 74, 2491.

[17] Origoni M., Sideri M., Garsia S. et al.: "Prognostic value of pathological patterns of lymph node positivity in squamous cell carcinoma of the vulva stage III and IVa F IGO". Gynecol. Oneal., 1992, 45,313.

[18] Iversen T., Aalders J.G., Christensen A. et al.: "Squamous cell carcinoma of the vulva: a review of 424 patients, 1956-74". Gynecol. Oneal., 1980, 9, 271.

[19] Andersen B.L., Hacker N.F.: "Psychosexual adjustment after vulvar surgery". Obstet. Gynecol., 1983, 62, 457.

[20] Sutton G.P.,M iser M.R.,S tehman F.B. et al.: "Trends in the operative management of invasive squamous carcinoma of the vulva at Indiana University. 1974-88". Am. J. Obstet. Gynecol., 1991, 164, 1472.

[21] Iversen T., Abeler V., Aalders J.: "Individualized treatment of stage I carcinoma of the vulva". Obstet. Gynecol., 1981, 57, 85.

[22] Hacker N.F., Berek J.S., Lagasse L.D. et al.: "Individualization of treatment of stage I squamous cell vulvar carcinoma". Obstet. Gynecol., 1984, 63, 155.

[23] Iversen T., Aas M.: "The lymph drainage of the vulva". Gynecol. Oncol., 1983, 16, 179.

[24] Iversen T.: "Squamous cell carcinoma of the vulva. Localization of the primary tumor and lymph node metastases". Acta Obstet. Gynecol. Scand., 1981, 60, 211.

[25] Hacker N.F., Leuchter R.S., Berek J.S. et al.: "Radical vulvectomy and bilateral inguinal lymphadenectomy through seperate groin incisions". Obstet. Gynecol., 1981, 58, 574.

[26] Hopkins M.P., Reid G., Morley G.W.: "The surgical management of recurrent squamous cell carcinoma of the vulva". Obstet. Gynecol., 1990, 75, 1001.

[27] Burke T.W., Stringer C.A., Gershenson D.M. et al.: "Radical wide excision and selective inguinal node dissection for squamous cell carcinoma of the vulva". Gynecol. Oneal., 1990, 38, 328.

[28] Van Trappen P.O. et al.: "Molecular quantification and mapping of lymph node micrometastasis in cervical cancer". Lancet, 2001, 357, 15.