International Journal of Hematology and Oncology 2024, Vol 34, Num 1 Page(s): 020-027
The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer

Derya A. CIRIK1, Alper KARALOK1, Isin UREYEN1, Osman TURKMEN1, Tolga TASCI1, M. Ali NARIN1, Mehmet F. KOSE2, Nurettin BORAN1, Taner TURAN1, Gokhan TULUNAY1

1Etlik Zübeyde Hanım Women’s Health Training and Research Hospital, Department of Gynecologic Oncology, Ankara, TURKEY
2Medipol University School of Medicine, Department of Obstetrics and Gynecology, Istanbul, TURKEY

Keywords: Vulvar cancer, lymph node, disease free survival, recurrence
We aimed to determine the prognostic significance of tumor and lymph node (LN) characteristics on disease free survival (DFS) in patients who underwent surgery for squamous cell vulvar carcinoma. A total of 94 patients who underwent vulvar surgery and groin dissection were included. The impact of clinicopathologic variables such as age, body mass index, tumor size, tumor depth, total and metastatic lymph node number on DFS were assessed. The estimates of survival were determined with Kaplan-Meier and log rank analysis. In the univariate analysis; age, body mass index, tumor size, tumor location, total LN number, metastatic LN number and adjuvant therapy did not have impact on DFS. The median number of removed LNs was 21. Although removal of higher number of lymph nodes did not improved the DFS, patients who had ≤ 3 metastatic LNs had better 2-year DFS rate compared to those with >3 metastatic LNs (71.8% vs 40.0%; p= 0.042, respectively). In the multivariate analysis, both the depth of tumor invasion and LN involvement were the independent predictors of DFS. Additionally, in stage III disease, patients receiving adjuvant therapy had significantly less locoregional recurrence compared to those who did not receive. The presence of LN metastasis and increased tumor depth (> 3 mm) are poor prognostic factors for DFS in squamous cell vulvar cancer. Although the number of lymph nodes removed was not correlated with DFS, patients who had ≤ 3 metastatic LNs had better DFS compared to those with > 3 LNs.