Recurrence patterns and prognostic factors in Chinese patients with squamous cell carcinoma of the vulva treated with primary surgery.

The purpose of this study was to identify the prognostic factors for disease-free survival (DFS) and recurrence patterns in Chinese women with squamous cell carcinoma of the vulva treated with primary surgery. From 1980 through 2002, 100 patients with invasive squamous cell carcinoma of the vulva treated with primary surgery were included in this retrospective study. Survival analyses included the Kaplan-Meier method, log-rank test, and Cox proportional hazards model. The 5- and 10-year DFS rates were 66.5% and 45.2%, respectively. Among all the tumor-related variables age, International Federation of Gynecology and Obstetrics stage, lymphovascular space invasion, and lymph node status were found to be significant predictors of DFS for the univariate analysis. Multivariate analysis proved that age (risk ratio, 6.572; 95% confidence interval, 1.759-24.546) and lymph nodes metastasis (risk ratio, 4.178; 95% confidence interval, 1.358-12.855) were the most significant prognostic factors of DFS (P < 0.05). The overall recurrence rate was 34.0% (34/100). Among the patients with recurrences, the locations of the recurrent disease were as follows: local recurrence in 20 (58.8%), groin recurrence in 2 (5.9%), local and groin in 1 (2.9%), distant metastases in 5 (14.7%), and local recurrence and distant metastases in 5 (14.7%); data were missing for 1 (2.9%) patients. Older age and lymph nodes metastases were the independent predictors of poor prognosis for patients with invasive squamous cell carcinoma of the vulva treated with primary surgery. Local recurrence was the main recurrence pattern after primary surgery which would be improved by multidisciplinary treatment.