Study of biomolecular and clinical prognostic factors in patients with cancer of the vulva undergoing surgical treatment.

INTRODUCTION: Cancers of the vulva account for 3% to 5% of all cancers of the female genital. This study was conducted to evaluate clinical, pathological, and molecular prognostic factors in patients with cancer of the vulva. METHODS: Patients with squamous cell carcinoma of the vulva who had undergone surgical treatment at the Department of Pelvic Surgery and Gynecology Service, Aristides Maltez Hospital, between June 1993 and June 2011 were selected. Clinical, epidemiological, pathological, and molecular characteristics related to the prognosis of these patients were evaluated in relation to the prognosis. In the molecular evaluation, we studied the expression of p53 and matrix metalloproteinase 2 by immunohistochemistry. RESULTS: Seventy-five patients were eligible for the study. In multivariable analysis, factors related to survival were as follows: tumor size larger than 4 cm (P = 0.014), an invasion depth greater than 2 mm (P = 0.023) and matrix metalloproteinase 2 expression in more than 50% of the tumor cells (P = 0.046). With the use of the relative risks of the factors identified in the multivariable analysis, a point count was developed for a prognostic classification (the score classifies patients into 3 categories). CONCLUSIONS: A tumor size larger than 4 cm, an invasion depth greater than 2 mm, and metalloproteinase 2 expression in more than 50% of the tumor cells seem to be related to lower overall survival rate in patients with cancer of the vulva undergoing surgical treatment. A classification of the patient's prognosis can be performed using a point count based on these relative risks.

Análise da expressão do fator de crescimento vascular endotelial (VEGF) e do receptor do fator de crescimento epitelial (EGFR) como fatores prognósticos moleculares para metástases hepáticas de câncer colorretal / / Analisys of the expression of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) as molecular prognostic factors in patients with liver metastases from colorectal cancer

A ressecção hepática é o mais efetivo tratamento para os pacientes portadores de metástases hepáticas de câncer colorretal (CCR). Em 5 anos, a sobrevida estimada é de 25 a 57 % após a ressecção hepática. Atualmente, para avaliar o prognóstico da metástase hepática, alguns marcadores biológicos têm sido investigados e novos fatores de risco identificados, influenciando a sobrevida dos pacientes submetidos à cirurgia hepática. Este estudo avaliou retrospectivamente 83 pacientes submetidos à ressecção hepática por metástase colorretal. Nós avaliamos a expressão do VEGF e do EGFR no tecido tumoral, pelo método de "tissue array" e a intensidade da expressão, através do modo automatizado, utilizando o programa ACIS. A análise dos resultados associou a expressão dos VEGF e do EGFR no tecido tumoral com a sobrevida dos pacientes operados. Neste estudo, a expressão do VEGF na metástase hepática de câncer colorretal foi identificada como fator prognóstico independente. A expressão do EGFR não apresentou impacto na sobrevida, bem como não esteve relacionado a nenhuma das variáveis histopatológicas.

Hepatic resection is the most effective treatment option available for patients with liver metastases from colorectal carcinoma (CRC). Several large series have reported a 25 to 57 percent long-term survival rate after curative resection of liver metastases. To evaluate the prognosis of liver metastasis, several biological markers have been investigated and new risk factors have been reported to influence survival after liver metastasis resection. This study assessed retrospectively 83 patients operated with curative intent, with the diagnosis of liver metastasis of colorectal cancer. We assessed the impact on survival of the expression of VEGF and EGFR in the tumoral tissue through the method of tissue array and trough an automated manner, with the ACIS program. In this study, vascular endothelial growth factor expression in liver metastatic from colorectal carcinoma showed to be an important prognostic marker. Wherever, EGFR did not show an impact on survival, and was not related to any of the histopathological variables