Predictors and Patterns of Recurrence in Vulvar Cancer.

IF 1.6 4区 医学 Q4 ONCOLOGY
Francesca De Maria, Francesco Raspagliesi, Vito Chiantera, Umberto Leone Roberti Maggiore, Simone Bruni, Camilla Valsecchi, Ilaria Cuccu, Valentina Chiappa, Fabio Ghezzi, Giovanni Scambia, Jvan Casarin, Giorgio Bogani
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引用次数: 0

Abstract

Objective: To identify prognostic factors predicting recurrence in vulvar cancer patients undergoing surgery.

Methods: We retrospectively evaluated data from consecutive patients with vulvar cancer treated between 2002 and 2024 in 2 Italian centers. Basic descriptive statistics and multivariable analysis were used to create predictive models for patient outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using a Cox proportional hazards model.

Results: The study included 283 patients diagnosed with vulvar cancer (239 with squamous cell carcinoma). The most frequent stages were stage I (50.9%) and stage III (30.4%). After a median follow-up of 27 months, 91 (32.2%) recurrences were observed, of which 20% were local, 6% were regional, and 6% were distant. The five-year DFS and OS were 46% and 60%, respectively. Multivariate analysis identified the presence of positive lymph nodes (hazard ratio [HR]: 3.54, 95% confidence interval [CI]: 1.04-12.08), age (HR: 1.02, 95% CI: 1-1.04), FIGO stage II (HR: 3.12, 95% CI: 1.24-7.87), and FIGO stage IV (HR: 3.85, 95% CI: 1.19-12.43) as factors associated with worse DFS. Positive nodes (HR: 2.64, 95% CI: 1.2-5.8) and tumor diameter >4 cm (HR: 1.89, 95% CI: 1.05-3.42) were associated with OS. FIGO stage >I was predictive of regional and distant recurrences, but no factor was found to correlate with local recurrence.

Conclusions: FIGO stage >I was predictive of regional and distant recurrences, while no factors influencing local recurrence were identified. Positive nodes, age, and FIGO stage >I correlated with DFS, whereas tumor diameter >4 cm and positive nodes influenced OS.

外阴癌复发的预测因素和模式。
目的:探讨外阴癌手术后复发的影响因素。方法:我们回顾性评估2002年至2024年在意大利2个中心连续治疗的外阴癌患者的数据。使用基本描述性统计和多变量分析来创建患者预后的预测模型。采用Cox比例风险模型分析5年无病生存期(DFS)和总生存期(OS)。结果:本研究纳入283例外阴癌患者(其中239例为鳞状细胞癌)。最常见的是I期(50.9%)和III期(30.4%)。中位随访27个月后,91例(32.2%)复发,其中20%为局部复发,6%为局部复发,6%为远处复发。5年DFS和OS分别为46%和60%。多因素分析发现淋巴结阳性(风险比[HR]: 3.54, 95%可信区间[CI]: 1.04-12.08)、年龄(HR: 1.02, 95% CI: 1-1.04)、FIGO II期(HR: 3.12, 95% CI: 1.24-7.87)和FIGO IV期(HR: 3.85, 95% CI: 1.19-12.43)是与DFS恶化相关的因素。阳性淋巴结(HR: 2.64, 95% CI: 1.2-5.8)和肿瘤直径bbb4cm (HR: 1.89, 95% CI: 1.05-3.42)与OS相关。FIGO分期>I可预测局部和远处复发,但未发现与局部复发相关的因素。结论:FIGO分期>可预测局部和远处复发,未发现影响局部复发的因素。阳性淋巴结、年龄和FIGO分期>I与DFS相关,而肿瘤直径>4 cm和阳性淋巴结影响OS。
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来源期刊
CiteScore
4.90
自引率
0.00%
发文量
130
审稿时长
4-8 weeks
期刊介绍: ​​​​​​​American Journal of Clinical Oncology is a multidisciplinary journal for cancer surgeons, radiation oncologists, medical oncologists, GYN oncologists, and pediatric oncologists. The emphasis of AJCO is on combined modality multidisciplinary loco-regional management of cancer. The journal also gives emphasis to translational research, outcome studies, and cost utility analyses, and includes opinion pieces and review articles. The editorial board includes a large number of distinguished surgeons, radiation oncologists, medical oncologists, GYN oncologists, pediatric oncologists, and others who are internationally recognized for expertise in their fields.
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