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Impact of re-excision of residual adjacent vulvar intraepithelial neoplasia (VIN III) and histological tumour-free margin (hTFM) on survival in primary squamous cell carcinoma of vulva

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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Author notes

  1. Khayal Gasimli and Martina Straussner authors contributed equally to this study.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Khayal Gasimli, Martina Straussner, Iryna Schmeil, Thomas Karn, Sven Becker & Ahmed El-Balat

  2. Dr. Senckenberg Institute of Pathology, Frankfurt, Germany

    Ria Winkelmann

Authors
  1. Khayal Gasimli
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  2. Martina Straussner
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  3. Iryna Schmeil
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  4. Thomas Karn
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  5. Ria Winkelmann
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  6. Sven Becker
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  7. Ahmed El-Balat
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Contributions

KG: data collection and management, data analysis, statistical analysis (descriptive), manuscript writing and editing; MS: data collection and management, data analysis; IS: data collection; RW: histological examination; TK: data analysis, statistical analysis (correlation, survival); SB: project development; AE-B: protocol and project development, manuscript correction.

Corresponding author

Correspondence to Khayal Gasimli.

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No financial or personal conflict of interest by any of the authors to declare.

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Gasimli, K., Straussner, M., Schmeil, I. et al. Impact of re-excision of residual adjacent vulvar intraepithelial neoplasia (VIN III) and histological tumour-free margin (hTFM) on survival in primary squamous cell carcinoma of vulva. Arch Gynecol Obstet 298, 945–950 (2018). https://doi.org/10.1007/s00404-018-4887-1

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  • DOI: https://doi.org/10.1007/s00404-018-4887-1

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