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. 2021 Aug;304(2):511-519.
doi: 10.1007/s00404-020-05949-w. Epub 2021 Jan 9.

A risk factor analysis of complications after surgery for vulvar cancer

Georgios Gitas  1 , L Proppe  2 , S Baum  2 , M Kruggel  2 , A Rody  2 , D Tsolakidis  3 , D Zouzoulas  3 , A S Laganà  4 , V Guenther  5 , D Freytag  5 , I Alkatout  5
Affiliations

A risk factor analysis of complications after surgery for vulvar cancer

Georgios Gitas et al. Arch Gynecol Obstet. 2021 Aug.

Abstract

Introduction: Despite the less frequent use of surgery in patients with vulvar cancer, the high rates of postoperative complications are still a matter of concern. The aim of the present study was to identify risk factors that influence postoperative complications rates in vulvar cancer and identify specific clinical parameters that may influence their incidence.

Materials: Patients who underwent curative-intent surgery for squamous cell carcinoma of the vulva from 2003 to 2018 were selected. All patient characteristics were analyzed as risk factors for the development of postoperative lymphocele, lymphedema, and wound dehiscence. The patients were followed up for 2 years postoperatively.

Results: The investigation comprised 121 patients, of whom 18.1% developed wound dehiscence, 17.7% a lymphocele, and 20.4% lymphedema. We found no significant evidence of an association between patient's characteristics and postoperative complications. The depth of tumor invasion and the appearance of lymph-node metastasis were significantly associated with postoperative complications. Free resection margins of 5 mm or more were associated with a reduced risk of postoperative complications compared to resection margins less than 5 mm. No complications were encountered after sentinel node biopsy (SNB). Complication rates were associated with inguinofemoral lymphadenectomy, but not with the extent of lymphadenectomy. The development of a lymphocele or wound dehiscence may be correlated with the development of long-term lymphedema.

Conclusion: FIGO stage at diagnosis influences the risk of postoperative complications. The use of SNB minimized postoperative complications. Correlations between the free microscopic resection margin distance and the risk of postoperative wound dehiscence must be investigated further.

Keywords: Lymphedema; Postoperative complications; Resection margin; Vulvar cancer; Wound dehiscence.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Association between microscopic free resection margin in millimeters (mm) after vulvectomy and the risk of postoperative complications. Patients with a free resection margin of 5 mm do not have a significant increased risk developing postoperative complications compared to those with a free resection margin under 5 mm
See this image and copyright information in PMC

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