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. 2013 Jul;24(3):242-8.
doi: 10.3802/jgo.2013.24.3.242. Epub 2013 Jul 4.

Prognostic factors associated with local recurrence in squamous cell carcinoma of the vulva

Sara Iacoponi  1 , Ignacio Zapardiel, Maria Dolores Diestro, Alicia Hernandez, Javier De Santiago
Affiliations

Prognostic factors associated with local recurrence in squamous cell carcinoma of the vulva

Sara Iacoponi et al. J Gynecol Oncol. 2013 Jul.

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 ≤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.

Keywords: Margin distance; Prognostic factors; Recurrence rate; Vulvar carcinoma.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Recurrence-free survival rate according to pathologic tumor-free margin.
Fig. 2
Fig. 2
Recurrence-free survival rate according to stromal invasion.
Fig. 3
Fig. 3
Recurrence-free survival rate according to tumor size.
See this image and copyright information in PMC

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