Journal article
Role of Locoregional Treatment in Vulvar Cancer With Pelvic Lymph Node Metastases: Time to Reconsider FIGO Staging?
Journal of the National Comprehensive Cancer Network, v 17(8), pp 922-930
01 Aug 2019
PMID: 31390593
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Vulvar cancer with pelvic nodal involvement is considered metastatic (M1) disease per AJCC staging. The role of definitive therapy and its resulting impact on survival have not been defined. Patients and Methods: Patients with pelvic lymph node-positive vulvar cancer diagnosed in 2009 through 2015 were evaluated from the National Cancer Database. Patients with known distant metastatic disease were excluded. Logistic regression was used to evaluate use of surgery and radiation therapy (RT). Overall survival (OS) was evaluated with log-rank test and Cox proportional hazards modeling (multivariate analysis [MVA]). A 2-month conditional landmark analysis was performed. Results: A total of 1,304 women met the inclusion criteria. Median follow-up was 38 months for survivors. Chemotherapy, RT, and surgery were used in 54%, 74%, and 62% of patients, respectively. Surgery was associated with prolonged OS (hazard ratio [HR], 0.58; P<.001) but had multiple significant differences in baseline characteristics compared with nonsurgical patients. In patients managed nonsurgically, RT was associated with prolonged OS (HR, 0.66; P=.019) in MVA. In patients undergoing surgery, RT was associated with better OS (3-year OS, 55% vs 48%; P=.033). Factors predicting use of RT were identified. MVA revealed that RT was associated with prolonged OS (HR, 0.75; P=.004). Conclusions: In this cohort of women with vulvar cancer and positive pelvic lymph nodes, use of RT was associated with prolonged survival in those who did not undergo surgery. Surgery followed by adjuvant RT was associated with prolonged survival compared with surgery alone.
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Details
- Title
- Role of Locoregional Treatment in Vulvar Cancer With Pelvic Lymph Node Metastases: Time to Reconsider FIGO Staging?
- Creators
- Ashwin Shinde - National Atmospheric Research LaboratoryRichard Li - National Atmospheric Research LaboratoryArya Amini - National Atmospheric Research LaboratoryYi-Jen Chen - City Of Hope National Medical CenterMihaela Cristea - City Of Hope National Medical CenterWenge Wang - City Of Hope National Medical CenterMark Wakabyashi - City Of Hope National Medical CenterErnest Han - City Of Hope National Medical CenterCatheryn Yashar - University of California, San DiegoKevin Albuquerque - The University of Texas Southwestern Medical CenterSushil Beriwal - University of Pittsburgh Medical CenterScott Glaser - National Atmospheric Research Laboratory
- Publication Details
- Journal of the National Comprehensive Cancer Network, v 17(8), pp 922-930
- Publisher
- Harborside Press
- Number of pages
- 12
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000487240600006
- Scopus ID
- 2-s2.0-85071928367
- Other Identifier
- 991021897372504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology