Surgical treatment of vulvar cancer: Impact of tumor-free margin distance on recurrence and survival. A multicentre cohort analysis from the francogyn study group.
Adult
Aged
Aged, 80 and over
Carcinoma in Situ
/ pathology
Carcinoma, Squamous Cell
/ epidemiology
Cohort Studies
Disease-Free Survival
Female
France
/ epidemiology
Humans
Lymph Node Excision
Margins of Excision
Middle Aged
Neoplasm Recurrence, Local
/ epidemiology
Neoplasm Staging
Prognosis
Retrospective Studies
Sentinel Lymph Node Biopsy
Survival Rate
Tumor Burden
Vulvar Lichen Sclerosus
/ epidemiology
Vulvar Neoplasms
/ epidemiology
Recurrence
Survival
Tumor-free margin
Vulvar cancer
Journal
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
24
03
2019
revised:
24
06
2019
accepted:
02
07
2019
pubmed:
10
7
2019
medline:
19
6
2020
entrez:
10
7
2019
Statut:
ppublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 31285094
pii: S0748-7983(19)30542-6
doi: 10.1016/j.ejso.2019.07.005
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2109-2114Informations de copyright
Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.