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Korean Journal of Obstetrics & Gynecology 2007;50(9):1233-1239.
Published online September 1, 2007.
Predicting parameters of survival in patients with vulva carcinoma: its relationship with human papillomavirus infection.
Joung Sub Youn, Eun Ji Nam, Bo Sung Yoon, Sang Wun Kim, Jae Hoon Kim, Young Tae Kim, Jae Wook Kim, Sunghoon Kim
1Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea. shkim70@yumc.yonsei.ac.kr
2Women's Cancer Clinic, Yonsei University College of Medicine, Seoul, Korea.
3Department of Obstetrics and Gynecology, College of Medicine, Pochon CHA University, Korea.
4Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Myung-ji Hospital, Kwandong University College of Medicine, Kyunggi-do, Korea.
Abstract
OBJECTIVES
This study was conducted to evaluate the relationship between HPV infection status and clinicopathologic parameters and to define the predictive parameters including treatment modality affecting survival in patients with vulva cancer. MATERIALS AND METHODS: Data were collected from 30 patients who were diagnosed for vulva carcinoma from Jan 1991 to June 2005. The cancer-related variables including age, stage, cell type, lesion size, multifocality, lymph node involvement, treatment modality and HPV infection were evaluated by reviewing medical records. Statistical analysis was performed by chi-square, log rank test and Cox proportional hazards analysis using SPSS program. RESULTS: Among all 30 patients of vulva carcinoma, HPV infection status was tested in 17 patients. And of these patients, 11 (64.7%) had positive HPV infection. Although there was no survival difference according to HPV infection status, patients with positive HPV infection had significantly more positive lymph nodes (p=0.04). Among all the cancer-related variables, radiation therapy was significantly more associated with poor overall survival than surgery (p=0.007). And squamous cell type was related with decreased overall survival although not statistically significant (p=0.06). However, on the basis of multivariate analysis, there was no significant independent prognostic factor affecting overall survival for vulva carcinoma. CONCLUSIONS: Although this study didn't show any direct relationship between HPV infection and prognosis, HPV infected patients were significantly associated with lymph node metastasis. And the surgery might be an important treatment modality affecting overall survival in patients with vulva carcinoma.
Key Words: Vulvar cancer, HPV, Treatment
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