HISTOLOGIC PREDICTIVE FACTORS - THERAPEUTIC IMPACT IN VULVAR CANCER

In 59 cases of vulvar invasive squamous cell carcinoma treated with ra dical vulvectomy and inguinofemoral lymphadenectomy, seven histologic parameters were evaluated to establish their predictive value in the d evelopment of lymph node metastasis. The most significant was vascular involvement, observed in 86% of cases with lymph node metastases (P < .000004). Depth of stromal invasion and tumor thickness were highly si gnificant, with P <.008 and <.007, respectively, with 0% lymph node me tastases in tumours thinner than 1 mm and 62% and 60%, respectively, i n those thicker than 5 mm. The growth pattern correlated with lymph no de metastases but was not statistically significant. The histologic gr ade correlated with positive lymph nodes, with P<.04. The amount of ke ratin (P <.91) was not related. These histologic factors allow the ide ntification of patients with a lower risk of developing lymph node met astases and in whom conservative surgery on the vulva and inguinofemor al lymph nodes is feasible.