Back to Search
Start Over
Surgical treatment of vulvar cancer: Impact of tumor-free margin distance on recurrence and survival. A multicentre cohort analysis from the francogyn study group.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2019 Nov; Vol. 45 (11), pp. 2109-2114. Date of Electronic Publication: 2019 Jul 03. - Publication Year :
- 2019
-
Abstract
- Objective: In vulvar cancer, it is admitted that tumor-free margin distance is one of the most important element for locoregional control. It is currently recommended to surgically remove the tumor with at least an 8 mm tumor-free margin. The aim of this study was to evaluate the impact of tumor-free margin distance on recurrence and survival in vulvar cancer.<br />Material and Methods: From 2005 to 2016, 112 patients surgically treated for a vulvar squamous cell cancer were included in a retrospective multicenter study. Overall, disease-free and metastasis-free survivals were analyzed according to tumor-free margin distance.<br />Results: Patients were divided into three groups: group 1 (margin <3 mm, n = 47); group 2 (margin ≥3 mm to < 8 mm, n = 48) and group 3 (margin ≥8 mm, n = 17). During the study, 26,8% patients developed recurrence (n = 30) after a median of 8 months (1-69). Analysis of 5-year overall survival, as well as disease-free and metastasis-free survivals, did not reveal a difference between groups. We performed a subgroup analysis in patients with a tumor-free margin <8 mm (group 1 and 2). It showed that histological lesions observed closest to the edge of the specimen were more often invasive or in situ carcinoma lesions in group 1 than in group 2, in which VIN lesions were mainly observed at this location. After re-excision, no patients in group 1 and 50% (n = 2) patients in group 2 developed recurrence.<br />Conclusion: This study did not reveal a significant impact of tumor-free margin distance on recurrence and survival in vulvar cancer. Moreover, the benefit of re-excision seems stronger when tumor-free margins are positive or very close (<3 mm), cases in which invasive or in situ lesions are often present closest to the edge of the specimen.<br /> (Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma in Situ pathology
Carcinoma, Squamous Cell epidemiology
Carcinoma, Squamous Cell pathology
Cohort Studies
Disease-Free Survival
Female
France epidemiology
Humans
Lymph Node Excision
Middle Aged
Neoplasm Staging
Prognosis
Retrospective Studies
Sentinel Lymph Node Biopsy
Survival Rate
Tumor Burden
Vulvar Lichen Sclerosus epidemiology
Vulvar Neoplasms epidemiology
Vulvar Neoplasms pathology
Carcinoma in Situ surgery
Carcinoma, Squamous Cell surgery
Margins of Excision
Neoplasm Recurrence, Local epidemiology
Vulvar Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 45
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31285094
- Full Text :
- https://doi.org/10.1016/j.ejso.2019.07.005