Volume 8, Issue 2, June 2020, Page: 36-41
Factors Affecting Survival in Egyptian Patients with Advanced Vulval Cancer
Ahmed Aly Nagy, Department of Clinical Oncology, Ain Shams University, Cairo, Egypt
Ahmed Nader, Department of Clinical Oncology, Ain Shams University, Cairo, Egypt
Received: May 9, 2020;       Accepted: May 27, 2020;       Published: Jun. 8, 2020
DOI: 10.11648/j.crj.20200802.13      View  323      Downloads  94
Abstract
INTRODUCTION: Vulvar carcinoma accounts for about 4% of the female reproductive tract cancers and a total of 0.6% of all malignant cancers in females. PATIENTS AND METHODS: This retrospective study aimed to identify the possible risk factors which can impact survival in Egyptian patients with vulval cancer who received treatment at Ain Shams University department of clinical oncology and nuclear medicine in the period from 1-1-2007 till 1-1-2012. RESULTS: Our study included 64 patients [median age 63 years, median overall survival (OS) was 16.5 months]. The factors associated with favourable impact on OS were: Rural residence (17 versus 10 months for patients from urban residence, p=0.002), premenopausal status (19 versus 16 months in post menopausal patients, p<0.001), low grade histology (19 versus 10 months in patients with high grade, p<0.001) and negative resection margins (19 versus 10 months in case of positive margin, p<0.001). The factors associated with poor OS were: higher number of offspring (≥5 offspring, OS 10 versus 19 months if less than 5 offspring, p<0.001), patients presenting with ulcer rather than mass (11 versus 19 months, p<0.001 and those with bilateral disease (10 versus 17 months in unilateral disease, p=0.04), presence of ≥4 positive groin lymph nodes metastases (OS =16 months versus 17 months, p=0.047) tumor size ≥ 4 cm (10 versus 17 months in case of <4 cm, p=0.001) and depth of stromal invasion (17 versus 16 months in case of <1 cm and ≥ 1 cm respectively, p=0.015) CONCLUSION: Urbanization has been linked with more aggressive disease leading to decrease of OS. The age of onset of intercourse did not affect survival as was expected however multiple offspring which could be related to more frequent intercourse had an effect on survival. The offered treatment modalities did not show a superiority probably because all the patients presented in an advanced stage. The anatomical nature of this cancer might be the cause in delayed diagnosis which warrants health education projects for early detection. Further studies are required to assess the risk factors for development of vulval cancer in Egyptian patients.
Keywords
Vulva, Cancer, Retrospective
To cite this article
Ahmed Aly Nagy, Ahmed Nader, Factors Affecting Survival in Egyptian Patients with Advanced Vulval Cancer, Cancer Research Journal. Vol. 8, No. 2, 2020, pp. 36-41. doi: 10.11648/j.crj.20200802.13
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD: April 2015.
[2]
American Cancer Society. Cancer Facts and Figures 2018. Atlanta, Ga: American Cancer Society; 2018.
[3]
Ibrahim AS, Khaled HM, Mikhail N, Baraka H and Kamel H. Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program. J Cancer Epidemiol. 2014; 2014: 437971.
[4]
Eifel PJ, Berek JS, Markman MA. Cancer of the cervix, vagina, and vulva. In: DeVita VT Jr., Lawrence TS, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011. p. 1311-44.
[5]
Hacker NF, Eifel PJ, van der Veldenc J. FIGO cancer report 2012. Cancer of the vulva. Int J GynecolObstet 2012; 119 Suppl 2: S90-6.
[6]
Rakislova N, Saco A, Sierra A, Del Pino M, Ordi J. Role of Human Papillomavirus in Vulvar Cancer. Adv Anat Pathol. 2017 Jul; 24 (4): 201-214.
[7]
Committee Opinion No. 675 Summary: Management of Vulvar Intraepithelial Neoplasia. Obstet Gynecol. 2016 Oct. 128 (4): 937-8.
[8]
Creasman WT, Phillips JL, Menck HR. The National Cancer Data Base report on early stage invasive vulvar carcinoma. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1997 Aug 1. 80 (3): 505-13.
[9]
Hacker NF. Vulvar cancer. In: Berek JS, Hacker NF, editors. Berek and Hacker's Gynecologic Oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 536-75.
[10]
Khanna N, Rauh LA, Lachiewicz MP, Horowitz IR. Margins for cervical and vulvar cancer. J Surg Oncol. 2016 Mar. 113 (3): 304-9.
[11]
Gill BS, Bernard ME, Lin JF, Balasubramani GK, Rajagopalan MS, Sukumvanich P, et al. Impact of adjuvant chemotherapy with radiation for node-positive vulvar cancer: A National Cancer Data Base (NCDB) analysis. Gynecol Oncol. 2015 Jun. 137 (3): 365-72.
[12]
Shylasree TS, Bryant A, Howells RE. Chemoradiation for advanced primary vulval cancer. Cochrane Database Syst Rev. 2011 Apr 13.
[13]
Gadducci A, Cionini L, Romanini A, Fanucchi A, Genazzani AR. Old and new perspectives in the management of high-risk, locally advanced or recurrent, and metastatic vulvar cancer. Crit Rev Oncol Hematol. Ireland: 2006. 227-41.
[14]
Nicoletto MO, Parenti A, Del Bianco P, Lombardi G, Pedrini L, Pizzi S, Carli P, Della Palma M, Pastorelli D, Corti L, Becagli L. Vulvar cancer prognostic factors. Anticancer Res. 2010 Jun; 30 (6): 2311-7.
[15]
Okolo CA, Odubanjo MO, Awolude OA, Akang EE. A review of vulvar and vaginal cancers in Ibadan, Nigeria. N Am J Med Sci 2013; 6: 76-81.
[16]
Singh N, Negi N, Srivastava K, Agarwal G. A cohort study of vulvar cancer over a period of 10 years and review of literature. Indian J Cancer 2016; 53: 412-5.
[17]
Kehila M, ChanoufiM. Vulvar cancer in Tunisia: Epidemiological and clinicopathological features multicentric study. Journal of the Egyptian National Cancer Institute Volume 29, Issue 2, June 2017, Pages 95-98.
[18]
Kosary CL. FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973-87 SEER CASES of cancers of the endometrium, cervix, ovary, vulva and vagina. Seminars in surgical oncology 10 (1), 31-46, 1994.
[19]
Paladini D, Cross P, Lopes A, Monaghan J. Prognostic significance of lymph node variables in squamous cell carcinoma of the vulva. Cancer 74 (9), 2491-2496, 1994.
[20]
Lataifeh I., Carraro Nascimento M., Nicklin J., Perrin L., Crandon A., Obermair A. (2004) Patterns of recurrence and disease-free survival in advanced squamous cell carcinoma of the vulva. Gynecol Oncol 95: 701–705.
[21]
Oonk M., van Hemel B., Hollema H., de Hullu J., Ansink A., Vergote I., et al. (2010) Size of sentinel-node metastasis and chances of non-sentinel-node involvement and survival in early stage vulvar cancer: results from GROINSS-V, a multicentre observational study. Lancet Oncol 11: 646–652.
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