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Vulvar cancer recurrence - an analysis of prognostic factors in tumour-free pathological margins patients group.
- Source :
-
Ginekologia polska [Ginekol Pol] 2018; Vol. 89 (8), pp. 424-31. - Publication Year :
- 2018
-
Abstract
- Objectives: To evaluate risk factors associated with the local recurrence of invasive squamous cell vulvar cancer in patient group with tumor-free pathological margins.<br />Material and Methods: This is a retrospective analysis of 47 patients who underwent surgical treatment at University Hospital Brno, the Czech Republic between 2007 and 2014. 24 patients were classified as IB stage and three as II stage. A further 20 patients representing stage III showed the metastatic involvement of regional lymph nodes. Seven prognostic factors were analyzed in relation to local tumour recurrence: tumour size, margin distance, depth of invasion, lymphovascular space involvement (LVSI), midline involvement, metastatic lymph nodes and FIGO stage.<br />Results: All prognostic factors were found to be statistically significant with respect to the risk of local recurrence. The highest risk of local recurrence was observed for the depth of invasion > 5 mm (HR, 12.42 [95% CI; 3.44-44.84]) and for the presence of LVSI (HR, 10.83 [95% CI; 3.87-30.28]). The study also established a clear difference in the risk of local recurrence between patient groups with resection margin < 8 vs. ≥ 8 mm (HR, 4.91 [95% CI; 1.73-13.93; p = 0.003].<br />Conclusions: Tumour-free pathological margin of ≥ 8 mm is a major prognostic factor of local recurrence which can be influenced by the surgeon. A perfect knowledge of the extent of the disease prior to surgery supports adequately radical surgical trends. The emphasis is given on adequate radicality as well as on the reduction of overtreatment without worse-ning prognosis by simultaneously preserving the quality of life.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell secondary
Czech Republic
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Middle Aged
Neoplasm Staging
Neoplasm, Residual
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Vulvar Neoplasms pathology
Carcinoma, Squamous Cell surgery
Gynecologic Surgical Procedures adverse effects
Margins of Excision
Neoplasm Recurrence, Local
Vulvar Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0017-0011
- Volume :
- 89
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Ginekologia polska
- Publication Type :
- Academic Journal
- Accession number :
- 30215461
- Full Text :
- https://doi.org/10.5603/GP.a2018.0073