{"title":"Prognostic indicators and survival rates in vulvar cancer: insights from a retrospective study.","authors":"Tharinee Rahong, Panitta Sitthinamsuwan, Suchanan Hanamornroongruang, Khemanat Khemworapong, Vuthinun Achariyapota","doi":"10.1080/01443615.2025.2486183","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to ascertain prognostic indicators impacting progression-free survival (PFS) and overall survival (OS) in patients diagnosed with vulvar cancer. The secondary aim was to determine a quantifiable measure of PFS and OS for these patients.</p><p><strong>Methods: </strong>A comprehensive retrospective review was conducted of the medical records of vulvar cancer patients treated at Siriraj Hospital from 2006 to 2020. Patient characteristics, surgical outcomes, pathological features and immunohistochemical results for p16, p53 and PD-L1 were analysed for their potential as prognostic indicators for survival outcomes.</p><p><strong>Results: </strong>In the sample of 104 vulvar cancer patients, four factors were significantly associated with a worsening PFS. They were coexisting vulvar lesions such as lichen sclerosus and extramammary Paget's disease (<i>p</i> = .008); lymphovascular space invasion (LVSI; <i>p</i> = .011); pelvic or paraaortic lymph node metastases (<i>p</i> = .042); and positive p53 status (<i>p</i> = .046). Additionally, a tumour size exceeding 4 cm in diameter was significantly linked with decreased OS (<i>p</i> = .001). The median PFS and OS were calculated as 26.3 and 44.7 months, respectively. Significantly improved PFS and OS were noted in patients with a positive p16 or a negative p53 immunohistochemical profile. The calculated hazard ratios for these two subsets were 3.032 (95% CI = 1.419-6.480; <i>p</i> = .004) and 2.421 (95% CI = 1.120-5.232; <i>p</i> = .025), respectively.</p><p><strong>Conclusions: </strong>Factors leading to unfavourable PFS are coexisting vulvar lesions, positive LVSI status, pelvic or paraaortic lymph node metastases, and positive p53 status. Regarding OS, a tumour diameter exceeding 4 cm significantly correlates with poorer outcomes.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2486183"},"PeriodicalIF":0.9000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetrics and Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/01443615.2025.2486183","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/8 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: This study aimed to ascertain prognostic indicators impacting progression-free survival (PFS) and overall survival (OS) in patients diagnosed with vulvar cancer. The secondary aim was to determine a quantifiable measure of PFS and OS for these patients.
Methods: A comprehensive retrospective review was conducted of the medical records of vulvar cancer patients treated at Siriraj Hospital from 2006 to 2020. Patient characteristics, surgical outcomes, pathological features and immunohistochemical results for p16, p53 and PD-L1 were analysed for their potential as prognostic indicators for survival outcomes.
Results: In the sample of 104 vulvar cancer patients, four factors were significantly associated with a worsening PFS. They were coexisting vulvar lesions such as lichen sclerosus and extramammary Paget's disease (p = .008); lymphovascular space invasion (LVSI; p = .011); pelvic or paraaortic lymph node metastases (p = .042); and positive p53 status (p = .046). Additionally, a tumour size exceeding 4 cm in diameter was significantly linked with decreased OS (p = .001). The median PFS and OS were calculated as 26.3 and 44.7 months, respectively. Significantly improved PFS and OS were noted in patients with a positive p16 or a negative p53 immunohistochemical profile. The calculated hazard ratios for these two subsets were 3.032 (95% CI = 1.419-6.480; p = .004) and 2.421 (95% CI = 1.120-5.232; p = .025), respectively.
Conclusions: Factors leading to unfavourable PFS are coexisting vulvar lesions, positive LVSI status, pelvic or paraaortic lymph node metastases, and positive p53 status. Regarding OS, a tumour diameter exceeding 4 cm significantly correlates with poorer outcomes.
期刊介绍：
Journal of Obstetrics and Gynaecology represents an established forum for the entire field of obstetrics and gynaecology, publishing a broad range of original, peer-reviewed papers, from scientific and clinical research to reviews relevant to practice. It also includes occasional supplements on clinical symposia. The journal is read widely by trainees in our specialty and we acknowledge a major role in education in Obstetrics and Gynaecology. Past and present editors have recognized the difficulties that junior doctors encounter in achieving their first publications and spend time advising authors during their initial attempts at submission. The journal continues to attract a world-wide readership thanks to the emphasis on practical applicability and its excellent record of drawing on an international base of authors.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
