External genital tumors in women: role of differentiation, localization and histological types for predicting long-term survival value





external genital tumors, survival value, differentiation degree, histological type


Purpose of the study was to investigate the role of the tumor degree, localization and histological type of tumor at the level of long-term survival by 25-year retrospective observation in women with external genitalia cancer.

Materials and methods. 557 medical records of patients treated in National Cancer Institute have been analyzed during the period of 1993–2018 years. Impact of the differentiation degree, localization and histological type on the long-term survival value has been evaluated.

Results. It has been proved that the long-term survival value decreased by 27.3% during transition from high (G3) to intermediate (G2) tumor grade, by 10.8% during transition from intermediate (G2) to low (G1) tumor grade. The overall level of 25-year survival retrospectively constituted 45.0% with G3 tumor grade, 31.0% with G2, and 26.0% with G1 tumor grade (p <0.05).

The highest mortality has been demonstrated with total affection (66.7%), as well as with lesions of several zones (80.9%). The multiple Kaplan-Meier survival analysis showed that the most unfavorable localization was the area of labia minora, where the probability of survival at 25-year-long observation was 6.0% versus 23.0% for the primary tumor localization in the area of labia majora, and versus 35.0% in the vulvar region localization.

Conclusion. The highest rates of cancer mortality are verified in non-differentiated forms of tumor (100.0%) and for sarcoma (63.6%) depending on the morphological form of primary tumor. Mortality rate was more than 50.0% for all forms of squamous cell cancer. Carcinoma and adenocarcinoma with a level of mortality by 20.6 % and 21.4% respectively were more favorable compared to the other morphological forms.

Author Biographies

O. O. Samokhvalova, National Cancer Institute

Gynecologist-oncologist, Research Department of Oncogynecology

K. V. Kopchak, National Cancer Institute

MD, leading researcher, Research Department of Abdominal Tumors

Y. G. Tkalia, National Cancer Institute

PhD, gynecologist-oncologist, Research Department of Oncogynecology

V. S. Svintsitsky, National Cancer Institute

MD, professor, scientific head of the Research Department of Oncogynecology


Pushkarev, V.A., Mazitov, I.M., Khusnutdinov, Sh.M., Golov, E.K. “Analysis of the Clinicopathological Features of Vulvar Cancer.” Medical Bulletin of Bashkortostan 9.3 (2014): 50–4.

Nerodo, G.A., Nepomniashchaya, E.M., Nerodo, E.A. “The Clinical Course of Vulvar Cancer in Patients of Reproductive Age.” Creative Surgery and Oncology 3 (2012): 61–6.

Fedorenko, Z.P., Mikhailovich, Y.Y., Gulak, L.O., et al. Cancer in Ukraine 2016–2017. Incidence, Mortality, Performance Indicators of the Oncological Service. Bulletin of the National Cancer Register of Ukraine No. 19 (2018): 136 p.

Shalbaeva, R.S., Batyrkanova, G.K., Kamarly, Z.P., Makimbetov, E.K. “Epidemiological Aspects of Vulvar Cancer (Literature Review).” Bulletin of the Kyrgyz-Russian Slavic University 13.12 (2013): 189–193.

Haddad, H., Engohan-Aloghe, C., Belhaj, S., et al. “A very misleading vulvar tumor.” Ann Pathol 35.4 (2015): 368–70.

Alligood-Percoco, N.R., Kessler, M.S., Willis, G. “Breast cancer metastasis to the vulva 20 years remote from initial diagnosis: A case report and literature review.” Gynecol Oncol Rep 13 (2015): 33–5.

Perrone, G., Altomare, V., Zagami, M., et al. “Breastlike vulvar lesion with concurrent breast cancer: a case report and critical literature review.” In Vivo 23 (2009): 629–34.

Barlow, E.L., Kang, Y.J., Hacker, N.F., et al. “Changing Trends in Vulvar Cancer Incidence and Mortality Rates in Australia Since 1982.” Int J Gynecol Cancer 25.9 (2015): 1683–9.

Fuh, K.C. “Current management of vulvar cancer.” Hematology - Oncology Clinics of North America 26 (2012): 45.

Hacker, N.F., Barlow, E.L. “Staging for vulvar cancer.” Best Pract Res Clin Obstet Gynaecol 29.6 (2015): 802–11.

Go-Eun, B., Yoon, G., Yong-Jung, S., et al. “High-grade squamous intraepithelial lesion arising adjacent to vulvar lymphangioma circumscriptum: a tertiary institutional experience.” Oncotarget 7.30 (2016): 48120–9.

Koh, W.J., Greer, B.E., Abu-Rustum, N.R., et al. “Vulvar Cancer, Version 1. 2017, NCCN Clinical Practice Guidelines in Oncology.” J Natl Compr Canc Netw 15.1 (2017): 92–120.

Chokoeva, A.A., Tchemev, G., Cardoso, J.C., et al. “Vulvar sarcomas: short guideline for histopathological recognition and clinical management. Part 1.” Int J Immunopathol Pharmacol 28 (2015): 168–77.

Moore, D.H., Ali, S., Koh, W.J., et al. “A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally advanced squamous cell carcinoma of the vulva: a gynecologic oncology group study.” Gynecol Oncol 124.3 (2012): 529–33.

Joura, E.A., Ault, K.A., Bosch, F.X., et al. “Attribution of 12 high-risk human papillomavirus genotypes to infection and cervical disease.” Cancer Epidemiol Biomarkers Prev 23.10 (2014): 1997–2008.

Hay, C.M., Lachance, J.A., Lucas, F.L., et al. “Biomarkers p16, Human Papillomavirus and p53 Predict Recurrence and Survival in Early Stage Squamous Cell Carcinoma of the Vulva.” J Low Genit Tract Dis 20.3 (2016): 252–6.

Carter, J.S. “Vulvar and vaginal cancer.” Obstetrics & Gynecology Clinics of North America 39 (2012): 213.

Barlow, E.L., Kang, Y.J., Hacker, N.F., et al. “Changing Trends in Vulvar Cancer Incidence and Mortality Rates in Australia Since 1982.” Int J Gynecol Cancer 25.9 (2015): 1683–9.

Cooper S.M., Madnani, N., Margesson, L. “Reduced Risk of Squamous Cell Carcinoma With Adequate Treatment of Vulvar Lichen Sclerosus.” JAMA Dermatol 151.10 (2015): 1059–60.

Desouki, M.M., Chamberlain, B.K., Li, Z. “The role of immunohistochemistry in the evaluation of gynecologic pathology part 2: a comparative study between two academic institutes.” Ann Diagn Pathol 19.5 (2015): 296–300.

Chase, D.M., Lin, C.C., Craig, C.D., et al. “Disparities in Vulvar Cancer Reported by the National Cancer Database: Influence of Sociodemographic Factors.” Obstet Gynecol 126.4 (2015): 792–802.

Vyas, R., Thompson, C.L., Zargar, H., et al. “Epidemiology of genitourinary melanoma in the United States: 1992 through 2012.” J Am Acad Dermatol 75.1 (2016): 144–150.

Farrell, R.G., Hacker, N.F. “Quality of life after complete lymphadenectomy for vulvar cancer: do women prefer sentinel node biopsy?” Int J Gynecol Oncol 24.4 (2014): 813–9.

Hill-Daniel, J., Roett, M.A. “Genital Cancers in Women: Vulvar Cancer.” FP Essent 438 (2015): 31–43.

Groenen, S.M., Timmers, P.J., Burger, C.W. “Recurrence rate in vulvar carcinoma in relation to pathological margin distance.” Int J Gynecol Cancer 20.5 (2010): 869–73.

Tatarchuk, T., Yefimenko, O., Zanko, O., Schavinskaya, M. “Comparison of ultrasound investigation methods in postmenopause.” Georgian Med News 283 (2018): 19–26.

Doll, K.M., Meng, K., Basch, E.M., et al. “Gynecologic cancer outcomes in the elderly poor: A population-based study.” Cancer 121.20 (2015): 3591–9.






Tumors and pretumoral pathology