PROGNOSTIC FACTORS FOR GROIN NODE METASTASIS IN SQUAMOUS-CELL CARCINOMA OF THE VULVA (A GYNECOLOGIC-ONCOLOGY-GROUP-STUDY)
PROGNOSTIC FACTORS FOR GROIN NODE METASTASIS IN SQUAMOUS-CELL CARCINOMA OF THE VULVA (A GYNECOLOGIC-ONCOLOGY-GROUP-STUDY)
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DOI：
10.1006/gyno.1993.1127
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发表时间：
1993-06-01
影响因子：
4.7
通讯作者：
MORTEL, R
中科院分区：
文献类型：
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作者：
HOMESLEY, HD;BUNDY, BN;MORTEL, R
从 1977 年到 1984 年，妇科肿瘤学组 (GOG) 对外阴鳞状细胞癌 (n= 637) 进行了前瞻性临床和手术分期方案。先前报告的对象是具有浅表（5 毫米或以下侵入）病变的患者 (n = 272)。本报告的主题是基于所有 588 名可评估患者的预测腹股沟淋巴结转移的因素。对两份报告进行了比较。该组中几乎一半 (49.3%) 的肿瘤厚度最小 (⩽5 毫米)。几乎三分之一的患者有小的外阴病变（⩽2厘米）。直径≤2cm的肿瘤腹股沟淋巴结转移率为18.9%，直径>2cm的病灶腹股沟淋巴结转移率为41.6%。腹股沟淋巴结临床触诊的不准确性（23.9% 假阴性）在很大程度上导致了对疾病程度的低估。体重与检测阳性腹股沟淋巴结的敏感性无关（P=0.26）。使用逻辑模型，确定了阳性腹股沟淋巴结的独立预测因素（按重要性顺序）：根据GOG标准，肿瘤分化程度较低（P < 0.0001），可疑或固定/溃疡淋巴结（P < 0.0001），存在毛细血管淋巴受累（P < 0.0001），年龄较大（P = 0.0002）和较大的肿瘤厚度（侵袭）（P = 0.03）。病变大小和位置并不是腹股沟淋巴结阳性的独立预测因素。
From 1977 to 1984 the Gynecologic Oncology Group (GOG) conducted a prospective clinical and surgical staging protocol of squamous cell carcinoma of the vulva (n= 637). The patients with superficial (5 mm or less invasion) lesions were the subject of a previous report (n= 272). The subject of this report is on factors that predict groin node metastasis based on all 588 evaluable patients. Comparisons between the two reports are made. Almost half of this group (49.3%) had minimal tumor thickness (⩽5 mm). Almost one-third of patients had small vulvar lesions (⩽2 cm). Groin node metastasis was 18.9% for the ⩽2-cm diameter tumors and 41.6% for the >2-cm diameter lesions. The inaccuracy of clinical palpation of the groin nodes (23.9% false negative) largely accounts for underestimation of extent of disease. Body weight was not related to the sensitivity of detecting positive groin nodes (P= 0.26). Using the logistic model, independent predictors of positive groin nodes were identified (in order of importance): less tumor differentiation by GOG criteria (P< 0.0001), suspicious or fixed/-ulcerated nodes (P< 0.0001), presence of capillary-lymphatic involvement (P< 0.0001), older age (P= 0.0002), and greater tumor thickness (invasion) (P= 0.03). Lesion size and location were not independent predictors of positive groin nodes.