LymphedemaV1, Pmc, Corpus, bibRecord, 003315

Survival Outcomes for Patients with Stage IVB Vulvar Cancer with Grossly Positive Pelvic Lymph Nodes: Time to Reconsider the FIGO Staging System?

Identifieur interne : 003315 ( Pmc/Corpus ); précédent : 003314; suivant : 003316

Survival Outcomes for Patients with Stage IVB Vulvar Cancer with Grossly Positive Pelvic Lymph Nodes: Time to Reconsider the FIGO Staging System?

Auteurs : Nikhil G. Thaker ; Ann H. Klopp ; Anuja Jhingran ; Michael Frumovitz ; Revathy B. Iyer ; Patricia J. Eifel

Source :

Gynecologic oncology [ 0090-8258 ] ; 2014.

RBID : PMC:4329262

Abstract

Objective

To evaluate treatment outcomes for patients with vulvar cancer with grossly positive pelvic lymph nodes (PLNs).

Methods

From a database of 516 patients with vulvar cancer, we identified patients with grossly positive PLNs without distant metastasis at initial diagnosis. We identified 20 patients with grossly positive PLNs; inclusion criteria included PLN 1.5 cm or larger in short axis dimension on CT/MRI (n=11), FDG-avid PLN on PET/CT (n=3), or biopsy-proven PLN disease (n=6). Ten patients were treated with chemoradiation (CRT) therapy, 4 with RT alone, and 6 with various combinations of surgery, RT or CRT. Median follow-up time for patients who had not died of cancer was 47 months (range, 4-228 months).

Results

Mean primary vulvar tumor size was 6.4 cm; 12 patients presented with 2009 AJCC T2 and 8 with T3 disease. All patients had grossly positive inguinal nodes, and the mean inguinal nodal diameter was 2.8 cm. The 5-year overall survival and disease specific survival rates were 43% and 48%, respectively. Eleven patients had recurrences, some at multiple sites. There were 9 recurrences in the vulva, but no isolated nodal recurrences. Four patients developed distant metastasis within 6 months of starting radiation therapy.

Conclusions

Aggressive locoregional treatment can lead to favorable outcomes for many patients with grossly involved PLNs that is comparable to that of grossly involved inguinal nodes only. We recommend modification of the FIGO stage IVB classification to more accurately reflect the relatively favorable prognosis of patients with PLN involvement.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329262

DOI: 10.1016/j.ygyno.2014.12.013
PubMed: 25524458
PubMed Central: 4329262

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PMC:4329262

Le document en format XML

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<author><name sortKey="Thaker, Nikhil G" sort="Thaker, Nikhil G" uniqKey="Thaker N" first="Nikhil G." last="Thaker">Nikhil G. Thaker</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Klopp, Ann H" sort="Klopp, Ann H" uniqKey="Klopp A" first="Ann H." last="Klopp">Ann H. Klopp</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jhingran, Anuja" sort="Jhingran, Anuja" uniqKey="Jhingran A" first="Anuja" last="Jhingran">Anuja Jhingran</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
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<author><name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name>
<affiliation><nlm:aff id="A2">Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Iyer, Revathy B" sort="Iyer, Revathy B" uniqKey="Iyer R" first="Revathy B." last="Iyer">Revathy B. Iyer</name>
<affiliation><nlm:aff id="A3">Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Eifel, Patricia J" sort="Eifel, Patricia J" uniqKey="Eifel P" first="Patricia J." last="Eifel">Patricia J. Eifel</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Survival Outcomes for Patients with Stage IVB Vulvar Cancer with Grossly Positive Pelvic Lymph Nodes: Time to Reconsider the FIGO Staging System?</title>
<author><name sortKey="Thaker, Nikhil G" sort="Thaker, Nikhil G" uniqKey="Thaker N" first="Nikhil G." last="Thaker">Nikhil G. Thaker</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Klopp, Ann H" sort="Klopp, Ann H" uniqKey="Klopp A" first="Ann H." last="Klopp">Ann H. Klopp</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jhingran, Anuja" sort="Jhingran, Anuja" uniqKey="Jhingran A" first="Anuja" last="Jhingran">Anuja Jhingran</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name>
<affiliation><nlm:aff id="A2">Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Iyer, Revathy B" sort="Iyer, Revathy B" uniqKey="Iyer R" first="Revathy B." last="Iyer">Revathy B. Iyer</name>
<affiliation><nlm:aff id="A3">Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Eifel, Patricia J" sort="Eifel, Patricia J" uniqKey="Eifel P" first="Patricia J." last="Eifel">Patricia J. Eifel</name>
<affiliation><nlm:aff id="A1">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Gynecologic oncology</title>
<idno type="ISSN">0090-8258</idno>
<idno type="eISSN">1095-6859</idno>
<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To evaluate treatment outcomes for patients with vulvar cancer with grossly positive pelvic lymph nodes (PLNs).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">From a database of 516 patients with vulvar cancer, we identified patients with grossly positive PLNs without distant metastasis at initial diagnosis. We identified 20 patients with grossly positive PLNs; inclusion criteria included PLN 1.5 cm or larger in short axis dimension on CT/MRI (n=11), FDG-avid PLN on PET/CT (n=3), or biopsy-proven PLN disease (n=6). Ten patients were treated with chemoradiation (CRT) therapy, 4 with RT alone, and 6 with various combinations of surgery, RT or CRT. Median follow-up time for patients who had not died of cancer was 47 months (range, 4-228 months).</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Mean primary vulvar tumor size was 6.4 cm; 12 patients presented with 2009 AJCC T2 and 8 with T3 disease. All patients had grossly positive inguinal nodes, and the mean inguinal nodal diameter was 2.8 cm. The 5-year overall survival and disease specific survival rates were 43% and 48%, respectively. Eleven patients had recurrences, some at multiple sites. There were 9 recurrences in the vulva, but no isolated nodal recurrences. Four patients developed distant metastasis within 6 months of starting radiation therapy.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Aggressive locoregional treatment can lead to favorable outcomes for many patients with grossly involved PLNs that is comparable to that of grossly involved inguinal nodes only. We recommend modification of the FIGO stage IVB classification to more accurately reflect the relatively favorable prognosis of patients with PLN involvement.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">0365304</journal-id>
<journal-id journal-id-type="pubmed-jr-id">3932</journal-id>
<journal-id journal-id-type="nlm-ta">Gynecol Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Gynecol. Oncol.</journal-id>
<journal-title-group><journal-title>Gynecologic oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0090-8258</issn>
<issn pub-type="epub">1095-6859</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25524458</article-id>
<article-id pub-id-type="pmc">4329262</article-id>
<article-id pub-id-type="doi">10.1016/j.ygyno.2014.12.013</article-id>
<article-id pub-id-type="manuscript">NIHMS652268</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Survival Outcomes for Patients with Stage IVB Vulvar Cancer with Grossly Positive Pelvic Lymph Nodes: Time to Reconsider the FIGO Staging System?</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Thaker</surname>
<given-names>Nikhil G.</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Klopp</surname>
<given-names>Ann H.</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jhingran</surname>
<given-names>Anuja</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Frumovitz</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="A2">b</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Iyer</surname>
<given-names>Revathy B.</given-names>
</name>
<xref ref-type="aff" rid="A3">c</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eifel</surname>
<given-names>Patricia J.</given-names>
</name>
<xref ref-type="aff" rid="A1">a</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>a</label>
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</aff>
<aff id="A2"><label>b</label>
Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas</aff>
<aff id="A3"><label>c</label>
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas</aff>
<author-notes><corresp id="FN1"><label>*</label>
Corresponding author at: 1220 Holcombe Blvd., Houston, TX 77030-4004, USA. <email>peifel@mdanderson.org</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>17</day>
<month>1</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>12</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>2</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>2</month>
<year>2016</year>
</pub-date>
<volume>136</volume>
<issue>2</issue>
<fpage>269</fpage>
<lpage>273</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.ygyno.2014.12.013</pmc-comment>
      <permissions><copyright-statement>© 2014 Elsevier Inc. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To evaluate treatment outcomes for patients with vulvar cancer with grossly positive pelvic lymph nodes (PLNs).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">From a database of 516 patients with vulvar cancer, we identified patients with grossly positive PLNs without distant metastasis at initial diagnosis. We identified 20 patients with grossly positive PLNs; inclusion criteria included PLN 1.5 cm or larger in short axis dimension on CT/MRI (n=11), FDG-avid PLN on PET/CT (n=3), or biopsy-proven PLN disease (n=6). Ten patients were treated with chemoradiation (CRT) therapy, 4 with RT alone, and 6 with various combinations of surgery, RT or CRT. Median follow-up time for patients who had not died of cancer was 47 months (range, 4-228 months).</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Mean primary vulvar tumor size was 6.4 cm; 12 patients presented with 2009 AJCC T2 and 8 with T3 disease. All patients had grossly positive inguinal nodes, and the mean inguinal nodal diameter was 2.8 cm. The 5-year overall survival and disease specific survival rates were 43% and 48%, respectively. Eleven patients had recurrences, some at multiple sites. There were 9 recurrences in the vulva, but no isolated nodal recurrences. Four patients developed distant metastasis within 6 months of starting radiation therapy.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Aggressive locoregional treatment can lead to favorable outcomes for many patients with grossly involved PLNs that is comparable to that of grossly involved inguinal nodes only. We recommend modification of the FIGO stage IVB classification to more accurately reflect the relatively favorable prognosis of patients with PLN involvement.</p>
</sec>
</abstract>
<kwd-group><kwd>vulva</kwd>
<kwd>vulvar cancer</kwd>
<kwd>stage IVB</kwd>
<kwd>pelvic lymph nodes</kwd>
<kwd>radiation therapy</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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Survival Outcomes for Patients with Stage IVB Vulvar Cancer with Grossly Positive Pelvic Lymph Nodes: Time to Reconsider the FIGO Staging System?

Survival Outcomes for Patients with Stage IVB Vulvar Cancer with Grossly Positive Pelvic Lymph Nodes: Time to Reconsider the FIGO Staging System?

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki