IMR Press / EJGO / Volume 39 / Issue 1 / DOI: 10.12892/ejgo3570.2018

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Pathologic factors are poorly associated with local recurrence of vulvar cancer
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1 Department of Obstetrics and Gynecology, Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
2 Department of Pathology, Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
3 Department of Preventive Medicine, Biostatistics Shared Resource, Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
4 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Eur. J. Gynaecol. Oncol. 2018, 39(1), 5–9; https://doi.org/10.12892/ejgo3570.2018
Published: 10 February 2018
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.
Keywords
Vulvar neoplasm
Local neoplasm recurrence
Cancer-free margin
Surgical pathology
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