Histological mitotic count is a prognostic marker in vulvar sarcoma: a retrospective case series of 27 patients

This retrospective study analyzed 27 vulvar sarcoma patients treated at one institution (2005-2024). Mitotic count significantly predicted outcomes: patients with ≥20 mitoses/high power field (HPF) (N = 8) showed drastically worse recurrence-free survival (recurrence-free survival; hazard ratio [HR] = 15.48, 95% confidence interval [CI] = 2.67-89.70, P < 0.01) and overall survival (HR = 11.97, 95% CI = 1.40-102.22, P = 0.02) versus those with 0-9/HPF (N = 12). Despite adjuvant therapy, the ≥20/HPF group experienced high local and distant recurrence rates (both 62.5%). Mitotic count is a robust prognostic indicator, with ≥20 mitoses/HPF indicating poor survival outcomes even after comprehensive treatment.