Pathologic factors are poorly associated with local recurrence of vulvar cancer

C. Hoppenot, Ajit Singh Paintal, T. Catanzarite, A. Rademaker, J. Lurain*, N. Neubauer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate factors associated with an increased risk of local recurrence of squamous cell carcinoma (SCCA) of the vulva. Materials and Methods: Sixty-seven pathologic specimens of vulvar SCCA from 1991-2010 were retrospectively reviewed by a gynecologic pathologist. Medical records were reviewed for demographic, treatment, disease, and follow-up information. Risk of local recurrence was analyzed using Wilcoxon rank sum test and Fisher's analysis. Recurrence-free survival (RFS) was calculated with the Log Rank test and Cox regression. Results: Stage distribution in the 67 patients was: four (6.0%) Stage IA, 48 (77.6%) Stage IB, three (4.5%) Stage II, 11 (16.4%) Stage III, and one (1.5%) Stage IV. Overall five-year survival was 84% and median RFS was 84.8 months. Thirty-seven percent of patients (25/67) presented with a local recurrence at their initial re-presentation after initial treatment, accounting for 92.6% of initial recurrences. Rates of local recurrence were lower in non-Caucasians (p = 0.047) and when carcinoma in situ was present at the margin (p = 0.03). RFS was not affected by stage (p = 0.60), lymph node status (p = 0.55), tumor size (p=0.45), or pathologic factors. In particular, tumor distance from the surgical margins as a continuous variable or at any cut-off was not associated with either risk of local recurrence or shortened recurrence-free survival; however, there was a trend between prolonged RFS with increasing disease-free pathologic margin (p = 0.09). Conclusion: Risk of local recurrence and RFS of vulvar SCCA following surgical excision were not affected significantly by most clinical or pathologic variables, including lymph node status, and disease-free margin size.

Original languageEnglish (US)
Pages (from-to)5-9
Number of pages5
JournalEuropean Journal of Gynaecological Oncology
Volume39
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • Cancer-free margin
  • Local neoplasm recurrence
  • Surgical pathology
  • Vulvar neoplasm

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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