Clinical Analysis Of 64 Cases With Vulvar Cancer

Objective: To analyze retrospectively the clinical information of 64 patients with vulvar cancer in the Fourth Hospital of Hebei Medical University. To evaluate the related risk factors affecting prognosis and offer reference data for the individual treatment plan of vulvar cancer.Methods: The clinicopathologic factors and outcomes of 64 patients with vuvlar cancer, who underwent surgical treatment and confirmed by pathology, from Jan 1, 2003 to July 31, 2009 in the Fourth Hospital of Hebei Medical University, were reviewed and analyzed. All cases were follow-up visited and the last time for visition was May 31, 2010. 52 patients completed the follow-up visition, and the rate of follow-up visition was 81.3%. The 52 patients were analyzed in age, menopausaul stae, tumor size and site, stage, pathological type, histological grade, inguinal lymph node metastasis, lymphovascular space involvment, surgical range and the surgical range of inguinal lymph node dissection when there were no positive lymph node, to find the prognostic factors of vulvar cancer.Statistical analysis was performed using SPSS 13.0 software package. Kaplan-Meier method was used to calculate the survival rates. Evaluated the prognostic factors by univariate and multivariate analysis. Univariate analysis and the comparison between the survival rates was estimated by log-rank test. Multiple regression analysis were assessed by Cox proportional hazards model. Enumeration data were compared withχ2 test and Fisher exact tests. A statistically significant difference was indicated by P<0.05.Results:1 The median age of 64 cases with vulvar cancer was 54 years old (25~81 years old); <30 years old,≥30~<40 years old,≥40~<50 years old,≥50~<60 years old,≥60~<70 years old,≥70 years old account for 3.1%, 4.7%, 15.6%, 42.2%, 23.5%, 10.9%, respectively. 2 Between the different age groups, there were no significant differences in pathological type, histological grade and stage ( P>0.05 ) .3 There were no significant differences in pathological type, histological grade and stage between the premenopausal and menopausal groups ( P>0.05 ) .4 There was significant difference in tumor stage between the different tumor site group ( P<0.05 ). In the group of the tumor on median line, there were 6 patients in stageⅠ~Ⅱ( 6/15 ) , and 9 patients in stageⅢ~Ⅳ( 9/15 ) , while in the group of the tumor on labium majus and minus, there were 22 patients in stageⅠ~Ⅱ( 22/26 ) , and 4 patients in stageⅢ~Ⅳ( 4/26 ) .5 Comparison of various clinicopathologic factors related to inguinal lymph node metastasis, there were no significant differences in age, menopausal state, tumor size, tumor site, pathological type and histological grade ( P>0.05 ) .6 Univariate analysis revealed that tumor site, stage, lymphovascular space involvment, inguinal lymph node metastasis were significantly associated with the overall-survival.7 Multivariate analysis revealed that inguinal lymph node metastasis was the independent prognostic factor associated with overall-survival.8 The range of survival time was 3~87 months, the median survival time was 22.5 months.9 The 1-year, 3-year, 5-year overall survival rates after treatment were 84.6%, 67.5%, 67.5%, respectively.Conclusion:1 In the group of the tumor on median line, the incidence rate of stageⅢ~Ⅳwas higher, and the incidence rate of stageⅠ~Ⅱwas lower; while in the group of the tumor on labium majus and minus, the incidence rate of stageⅠ~Ⅱwas higher, and the incidengce rate of stageⅢ~Ⅳwas lower.2 Factors associated with prognosis were: Tumor site, operation-pathological stage, lymphovascular space involvement and inguinal lymph node metastasis. 3 Inguinal lymph node metastasis was the independent prognostic factor associated with overall-survival.