A low-risk group suitable for conservative surgery exists in patients with vulvar cancer.
Primary End Point:
Histologically positive groin nodes
Prospecitive group of vulvar cancer patients who were treated by radical vulvectomy and bilateral groin node dissection from 1977 to 1984 whose tumor size was noted to be superficial, = 5mm.
Tumor size > 5mm
272 women with tumor = 5mm
- 57 (21%) had positive groin lymph nodes
The proportion of patients with positive nodes rose steadily with each millimeter of thickness from:
- 3.1% if =1mm
- 8.9% if 2mm
- 18.6% if 3mm
- 30.9 if 4mm
- 33.3% if 5mm
Only 5 variables showed a statistically significant correlation with groin node metastasis: Clinical node status, tumor thickness, capillary-like space involvement, histologic tumor grade (Grade 1-4), and perineal or clitoral location.
These variables were used in a multivariate logistic model to predict node metastasis.
The lowest risk for lymph node metastases (0 observed, 2% expected) is a subset of patients with no clinically suspicious nodes, no LVSI, non-midline tumors that were either grade 1 (1-5mm thick) or grade 2 (1-2mm thick).
Laurel K Berry
All content on this website is free. You are free to copy and redistribute for non-commercial purposes. See details of the CC BY-NC 2.0 (Click here for details) To keep this website free and help this resource grow, consider becoming a patron (Click here for details)