Effect of known pathological risk factors on the incidence of metastatic lymph nodes and survival in early-stage vulvar cancer: SEER analysis Journal Article
| Authors: | Nahshon, C.; Leitao, M. M. Jr; Lavie, O.; Segev, Y. |
| Article Title: | Effect of known pathological risk factors on the incidence of metastatic lymph nodes and survival in early-stage vulvar cancer: SEER analysis |
| Abstract: | Objective: The current study was performed to evaluate the incidence of positive lymph nodes (LNs) in relation to known pathological risk factors, specifically among patients with apparent low-grade, small tumors. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to retrospectively identify patients with vulvar squamous cell carcinoma (SCC) diagnosed between January 1, 2000, and December 31, 2019, with known tumor size and regional LN examined. A comparison between patients who had positive and negative LNs was conducted to identify risk factors for LN metastases in relation to survival. Subgroup analysis was conducted in patients with diagnosed grade 1 vulvar SCC and tumor size up to 2 cm according to the status of LNs. Results: Multivariate analysis found that both grade of disease and tumor size were significant factors in predicting LN status. Among patients with low-grade small tumors up to 2 cm, the odds ratio for positive LNs was 2.5 for those with tumor size larger than 1 cm. In a multivariate survival analysis, older age, larger tumor size, and positive LNs were independently associated with decreased survival. Conclusions: The current study confirms that among small tumors, those larger than 1 cm have a significantly increased risk for positive nodes compared with those smaller than 1 cm, and, among this specific group, patients with positive nodes have decreased survival. Future studies are needed to answer the question of whether, in the era of the sentinel node procedure, it is safe to omit LN evaluation altogether. © 2023 International Federation of Gynecology and Obstetrics. |
| Keywords: | survival; adult; cancer survival; controlled study; aged; middle aged; survival analysis; survival rate; retrospective studies; young adult; major clinical study; histopathology; squamous cell carcinoma; carcinoma, squamous cell; comparative study; cancer staging; outcome assessment; follow up; lymph node metastasis; cancer diagnosis; cancer incidence; lymph node dissection; lymph nodes; lymphatic metastasis; neoplasm staging; sentinel lymph node; lymph node excision; tumor volume; clinical assessment; incidence; cohort analysis; risk factors; pathology; data base; retrospective study; risk factor; risk assessment; lymph node; clinical evaluation; cancer registry; multivariate analysis; metastases; vulvar cancer; vulvar neoplasms; procedures; early stage; vulva tumor; very elderly; humans; prognosis; human; female; article; vulvar squamous cell carcinoma; pathological risk factors |
| Journal Title: | International Journal of Gynecology and Obstetrics |
| Volume: | 164 |
| Issue: | 1 |
| ISSN: | 0020-7292 |
| Publisher: | Wiley-Blackwell Publishing Ltd. |
| Date Published: | 2024-01-01 |
| Start Page: | 339 |
| End Page: | 344 |
| Language: | English |
| DOI: | 10.1002/ijgo.15093 |
| PUBMED: | 37688303 |
| PROVIDER: | scopus |
| PMCID: | PMC11391884 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Scopus |
