Archives of Gynecology and Obstetrics, 2018, Vol.298(5), pp.945-950
To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00404-018-4887-1 Byline: Khayal Gasimli (1), Martina Straussner (1), Iryna Schmeil (1), Thomas Karn (1), Ria Winkelmann (2), Sven Becker (1), Ahmed El-Balat (1) Keywords: Squamous cell carcinoma of vulva; Re-excision of adjacent VIN III; Histological tumour-free margin; Vulvar intraepithelial neoplasia (VIN III); Disease-free survival Abstract: Background hTFM in primary vulvar cancer is an important prognostic factor. Ideally, a diameter of〉8 mm should be achieved after primary surgery. The role of VIN III persistence after primary surgery in vulvar cancer is still unclear. The main objective of the current study was to study the role of residual VIN III re-excision and compare differences in disease-free survival among patients with different hTFM and in primary vulvar cancer. Methods Forty-two patients with residual adjacent VIN III after primary surgery for vulvar cancer which were operated between 2000 and 2016 in our clinic were enrolled in this retrospective study. Re-excision rates for residual adjacent VIN III were calculated. According to the histological margin patients were divided into three group:〈3, 3--8 and〉8 mm. Univariate and multivariate analyses were conducted using the Kaplan--Meier method and Cox proportional hazards models, respectively. Results The vast majority of patients had pT1b stage (57.1%), grading G2 (71.4%) and lymph node-negative (45.3%) disease at first diagnosis. The re-excision rate was 57.1%. The 5-year disease-free survival (DFS) rates in patients with〈3, 3--8 and〉8 mm hTFM were 50.0, 50.0 and 81.0%, respectively (p=0.032). The 5-year DFS rates in patients with re-excision and without re-excision for VIN III were 77.3 and 52.9%, respectively (p=0.060). In univariate analysis was solely hTFM〉8 mm a prognostic factor for DFS (p=0.017). Conclusions hTFM may be a potential prognostic indicator for DFS in vulvar cancer patients. Re-excision for residual adjacent VIN III could not be established as a prognostic factor for DFS after primary surgery in squamous cell cancer of vulva. Author Affiliation: (1) 0000 0004 1936 9721, grid.7839.5, Department of Obstetrics and Gynecology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany (2) Dr. Senckenberg Institute of Pathology, Frankfurt, Germany Article History: Registration Date: 25/08/2018 Received Date: 13/05/2018 Accepted Date: 24/08/2018 Online Date: 06/09/2018 Article note: Khayal Gasimli and Martina Straussner authors contributed equally to this study.
Squamous cell carcinoma of vulva ; Re-excision of adjacent VIN III ; Histological tumour-free margin ; Vulvar intraepithelial neoplasia (VIN III) ; Disease-free survival
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