Futagami Masayuki, Yokoyama Yoshihito, Iino Kaori, Aoki Masahiko, Shoji Tadahiro, Sugiyama Toru, Ariga Hisanori, Tokunaga Hideki, Takano Tadao, Watanabe Yoh, Yaegashi Nobuo, Jingu Keiichi, Sato Naoki, Terada Yukihiro, Anbai Akira, Ohta Tsuyoshi, Kurachi Hirohisa, Kuroda Yuuki, Nishiyama Hiroshi, Fujimori Keiya, Watanabe Takafumi, Sato Hisashi, Tase Toru, Wada Hitoshi, Mizunuma Hideki
Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Int J Clin Oncol. 2015 Oct;20(5):1005-11. doi: 10.1007/s10147-015-0803-x. Epub 2015 Feb 24.
This multi-institutional study was conducted to clarify the clinicopathological features of squamous cell carcinomas of the vulva.
The medical records of vulvar cancer patients treated between 2002 and 2012 were retrospectively reviewed following approval by the Institutional Review Board of each institution.
One hundred and eleven patients with vulvar malignancies were included. Of these, 63 patients had squamous cell carcinoma (57 %). Initial treatment was surgery, radiation therapy (RT), and concurrent chemoradiotherapy (CCRT) in 34 (54 %), 15 (24 %), and 11 (17 %) patients, respectively. Nineteen, 11, 26, and 7 patients had stage I, II, III, and IV disease, respectively. Of the 34 patients who had surgical treatment, 50 % had stage I disease, while 74 % of those who received CCRT had stage III or IV disease. Complete response (CR) rates for the surgery, RT, and CCRT groups were 73, 60, and 64 %, respectively. The 5-year survival rates for stage I/II and III/IV disease were 64 and 39 %, respectively (P = 0.019). The 5-year survival rates for the surgery, RT, and CCRT groups were 53, 38, and 50 %, respectively, and the prognosis of patients treated with surgery or CCRT was significantly better than that of patients who received RT (P < 0.05). In multivariate analysis, clinical response to initial treatment was an independent prognostic factor (P < 0.001).
Although many patients had advanced-stage disease in the CCRT group, the therapeutic outcome for the surgery and CCRT groups was similar. Thus, CCRT may be a promising treatment for squamous cell carcinoma of the vulva.
本多机构研究旨在阐明外阴鳞状细胞癌的临床病理特征。
在各机构的机构审查委员会批准后,对2002年至2012年间接受治疗的外阴癌患者的病历进行回顾性分析。
共纳入111例外阴恶性肿瘤患者。其中,63例为鳞状细胞癌(57%)。初始治疗分别为手术、放射治疗(RT)和同步放化疗(CCRT),患者分别为34例(54%)、15例(24%)和11例(17%)。19例、11例、26例和7例患者分别处于I期、II期、III期和IV期。在接受手术治疗的34例患者中,50%为I期疾病,而接受CCRT的患者中74%为III期或IV期疾病。手术、RT和CCRT组的完全缓解(CR)率分别为73%、60%和64%。I/II期和III/IV期疾病的5年生存率分别为64%和39%(P = 0.019)。手术、RT和CCRT组的5年生存率分别为53%、38%和50%,接受手术或CCRT治疗的患者的预后明显优于接受RT治疗的患者(P < 0.05)。多因素分析显示,对初始治疗的临床反应是独立的预后因素(P < 0.001)。
尽管CCRT组中许多患者为晚期疾病,但手术组和CCRT组的治疗效果相似。因此,CCRT可能是外阴鳞状细胞癌的一种有前景的治疗方法。