Journal article
Optimal overall treatment time for adjuvant therapy for women with completely resected, node-positive vulvar cancer
Gynecologic oncology, v 161(1), pp 63-69
Apr 2021
PMID: 33500149
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The optimal overall treatment time (OTT) from radical surgery to the end of adjuvant radiation therapy for some squamous cell carcinomas has been found to impact treatment outcomes. This study aims to identify the impact of OTT on overall survival (OS) for women with completely resected, node-positive squamous cell carcinomas of the vulva.
The National Cancer Data Base was queried for women with surgically resected, node-positive vulvar squamous cell carcinomas between 2004 and 2016 who were treated with adjuvant radiation therapy. Kaplan-Meier analysis with log-rank test and Cox proportional hazards tests were utilized for OS calculations.
A total of 1500 women met inclusion criteria. The median OTT was 104 days. Shorter OTT was associated with age, facility volume, private insurance, and duration of post-operative hospitalization. Median OS with OTT ≤ 104 days was 56.1 months vs 45.4 months if ≥105 days (p = 0.015). On multivariable Cox analysis, OTT was independently associated with an increased risk of death of 0.4% per additional day (95%CI 1.001–1.007, p = 0.003), as were age at diagnosis (HR 1.031 [95%CI 1.024–1.037], p < 0.001), number of nodes positive (HR 1.031 [95%CI 1.024–1.037], p = 0.006), the use of concurrent chemotherapy (HR 0.815 [95%CI 0.693–0.960], p = 0.014) and increasing pT/pN stage. After propensity adjustment for factors predicting a shorter OTT, OTT continued to be associated with an increased risk of death per additional day (HR 1.004 [95%CI 1.001–1.007], p = 0.007).
Overall treatment time is an independent risk factor for death in women being treated with adjuvant radiation therapy following complete resection of node-positive squamous cell carcinoma of the vulva.
•OTT of adjuvant radiation therapy is an independent risk factor for death in women with resected, node-positive vulvar cancer•Each additional day between surgery and completion of adjuvant radiation contributes to higher risk of death•This is the first study to evaluate the impact of OTT on overall survival in this population of patients
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Details
- Title
- Optimal overall treatment time for adjuvant therapy for women with completely resected, node-positive vulvar cancer
- Creators
- Sarah Ashmore - Western Pennsylvania HospitalSarah M. Crafton - Allegheny Health NetworkEirwen M. Miller - Allegheny Health NetworkThomas C. Krivak - Allegheny Health NetworkScott M. Glaser - City Of Hope National Medical CenterSolomiya R. Teterichko - University of Pittsburgh Medical CenterPaniti Sukumvanich - University of Pittsburgh Medical CenterAkila N. Viswanathan - Johns Hopkins MedicineSushil Beriwal - University of Pittsburgh Medical CenterZachary D. Horne - Allegheny Health Network
- Publication Details
- Gynecologic oncology, v 161(1), pp 63-69
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000632713900009
- Scopus ID
- 2-s2.0-85099863153
- Other Identifier
- 991021897271804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology
- Oncology