Shanbour K A, Mannel R S, Morris P C, Yadack A, Walker J L
Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City.
Obstet Gynecol. 1992 Dec;80(6):927-30.
To compare prognostic information from the new surgical staging system of the International Federation of Gynecology and Obstetrics (FIGO) with the old clinical staging system for vulvar cancer.
One hundred six women with previously untreated squamous cell carcinoma of the vulva who underwent radical vulvectomies and inguinal lymph node dissections at the University of Oklahoma from 1971-1990 were considered eligible for this study. A retrospective chart review was conducted to assign surgical stage. The clinical and pathologic factors analyzed for survival included the clinical and surgical stage of disease, nodal status, tumor size, and lesion location.
Overall 5-year survival was 64%. Forty-three patients had inguinal and femoral node metastasis with a 5-year survival of 38%, versus 87% for patients without nodal metastasis (P < .00001). An increased number of positive groin lymph nodes was associated with a poorer prognosis. Thirty-one patients had tumors of 2 cm or less in maximum diameter with no recurrences, versus 52% 5-year survival in the remaining patients (P < .001). Perineal involvement was identified in 24 patients, but did not significantly influence survival.
Overall, the new classification system revised by FIGO for vulvar cancer staging places patients into more accurate risk categories.
比较国际妇产科联盟（FIGO）新的手术分期系统与旧的外阴癌临床分期系统所提供的预后信息。
1971年至1990年在俄克拉荷马大学接受根治性外阴切除术和腹股沟淋巴结清扫术的106例先前未经治疗的外阴鳞状细胞癌女性被认为符合本研究条件。进行回顾性病历审查以确定手术分期。分析的与生存相关的临床和病理因素包括疾病的临床和手术分期、淋巴结状态、肿瘤大小和病变位置。
总体5年生存率为64%。43例患者有腹股沟和股淋巴结转移，5年生存率为38%，而无淋巴结转移患者的5年生存率为87%（P <.00001）。腹股沟淋巴结阳性数量增加与预后较差相关。31例最大直径2 cm或更小的肿瘤患者无复发，其余患者的5年生存率为52%（P <.001）。24例患者有会阴受累，但对生存无显著影响。
总体而言，FIGO修订的外阴癌分期新分类系统将患者归入更准确的风险类别。
