Prognostic factors associated with local recurrence in squamous cell carcinoma of the vulva.
10.3802/jgo.2013.24.3.242
- Author:
Sara IACOPONI
1
;
Ignacio ZAPARDIEL
;
Maria Dolores DIESTRO
;
Alicia HERNANDEZ
;
Javier DE SANTIAGO
Author Information
1. Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain. ignaciozapardiel@hotmail.com
- Publication Type:Original Article
- Keywords:
Margin distance;
Prognostic factors;
Recurrence rate;
Vulvar carcinoma
- MeSH:
Carcinoma, Squamous Cell;
Humans;
Neoplasm Metastasis;
Recurrence;
Retrospective Studies;
Tertiary Care Centers;
Vulva
- From:Journal of Gynecologic Oncology
2013;24(3):242-248
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To analyze the prognostic factors related to the recurrence rate of vulvar cancer. METHODS: Retrospective study of 87 patients diagnosed of vulvar squamous cell carcinoma diagnosed at a tertiary hospital in Madrid between January 2000 and December 2010. RESULTS: The pathological mean tumor size was 35.1+/-22.8 mm, with stromal invasion of 7.7+/-6.6 mm. The mean free margin after surgery was 16.8+/-10.5 mm. Among all patients, 31 (35.6%) presented local recurrence (mean time 10 months; range, 1 to 114 months) and 7 (8%) had distant metastases (mean time, 5 months; range, 1 to 114 months). We found significant differences in the mean tumor size between patients who presented a relapse and those who did not (37.6+/-21.3 mm vs. 28.9+/-12.1 mm; p=0.05). Patients with free margins equal or less than 8 mm presented a relapse rate of 52.6% vs. 43.5% of those with free margin greater than 8 mm (p=0.50). However, with a cut-off of 15 mm, we observed a local recurrence rate of 55.6% vs. 34.5%, respectively (p=0.09). When the stromal invasion cut-off was >4 mm, local recurrence rate increased up to 52.9% compared to 37.5% when the stromal invasion was < or =4 mm (p=0.20). CONCLUSION: Tumor size, pathologic margin distance and stromal invasion seem to be the most important predictors of local vulvar recurrence. We consider the cut-off of 35 mm of tumor size, 15 mm tumor-free surgical margin and stromal invasion >4 mm, high risk predictors of local recurrence rate.
