Role of Locoregional Treatment in Vulvar Cancer With Pelvic Lymph Node Metastases: Time to Reconsider FIGO Staging?

Journal of the National Comprehensive Cancer Network : JNCCN
Ashwin ShindeScott Glaser

Abstract

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 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. 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 ...Continue Reading

References

Sep 25, 1998·International Journal of Radiation Oncology, Biology, Physics·D H MooreG Olt
Feb 27, 2007·International Journal of Radiation Oncology, Biology, Physics·Sushil BeriwalRobert P Edwards
Jan 10, 2008·Annals of Surgical Oncology·Karl Y BilimoriaClifford Y Ko
Jan 24, 2012·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Linn WoelberSven Mahner
Jan 1, 2013·International Journal of Radiation Oncology, Biology, Physics·Sushil BeriwalThomas C Krivak
Sep 24, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Firas AbdollahAlberto Briganti
Jan 27, 2015·Journal of the National Cancer Institute·Sven MahnerUNKNOWN AGO-CaRE 1 investigators
Oct 4, 2015·Gynecologic Oncology·Linda S NooijMariette I E van Poelgeest
May 1, 2016·International Journal of Radiation Oncology, Biology, Physics·David K GaffneyWalter Bosch
Jun 22, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Chad G RusthovenThomas J Pugh
Jul 13, 2016·Gynecologic Oncology·Katharina PrieskeLinn Woelber
Jul 26, 2017·Advances in Radiation Oncology·Yuan James RaoPerry W Grigsby
Jan 10, 2018·CA: a Cancer Journal for Clinicians·Rebecca L SiegelAhmedin Jemal
Jun 13, 2018·International Journal of Radiation Oncology, Biology, Physics·Alex K BryantBrent S Rose

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