Patterns of first recurrence and outcomes in surgically treated women with vulvar cancer: results from FRANCOGYN study group.
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
/ pathology
Databases, Factual
Disease-Free Survival
Female
Follow-Up Studies
France
/ epidemiology
Humans
Lymphatic Metastasis
/ pathology
Middle Aged
Neoplasm Invasiveness
/ pathology
Neoplasm Recurrence, Local
/ epidemiology
Neoplasm Staging
Prognosis
Retrospective Studies
Vulvar Neoplasms
/ pathology
LVSI
Prognostic factor
Recurrence
Vulvar cancer
Journal
Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
04
04
2020
revised:
13
04
2020
accepted:
14
04
2020
pubmed:
22
5
2020
medline:
28
8
2021
entrez:
22
5
2020
Statut:
ppublish
Résumé
Cancer of the vulva recurrences vary considerably over time and are influenced by several pathological, surgical and adjuvant therapeutic prognostic factors. However, limited information is available about patterns of disease recurrence and prognosis. We analysed patterns of vulvar cancer recurrence based on a large French multicentre database. Data of women with histologically proven squamous cell carcinoma (SCC) and other vulvar cancer treated between 1976 and 2016 were retrospectively abstracted from five institutions with prospectively maintained vulvar cancer databases in France. The endpoints were pattern of recurrence, recurrence free survival (RFS) and overall survival (OS). Time to the first recurrence in a specific site was evaluated by using cumulative incidence analysis (Gray's test) and competing risks regression analysis to estimate sub-distribution hazard ratios and 95% CIs. In the whole population, recurrences were observed in 188 of the 617 women (30%) with local-regional, distant and multifocal recurrences in 18% (109/617), 3% (17/617), 10% (62/617), respectively. The median time to recurrence with Interquartile Range (IQR) was 13 months IQR [8-30]. The overall respective 3-years OS and RFS were 78.5% (IC95%: 74.5-82.5) and 75.5% (IC95%: 71.1-80.0). According to FIGO stage, lymph node status and positive lympho-vascular invasion (LVSI), pattern and time of loco-regional and distant recurrence were significantly different. There wasn't interaction between FIGO stage and LVSI in OS neither RFS (p=0.08 and 0.9 respectively). We report specific time and site patterns of first recurrence according to FIGO stage, lymph node status and lymphovascular invasion status. Positive LVSI is an important and independent prognostic factor. Defining patterns of recurrence may provide useful information for developing follow-up recommendations and designing therapeutic approaches.
Identifiants
pubmed: 32438137
pii: S2468-7847(20)30118-5
doi: 10.1016/j.jogoh.2020.101775
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
101775Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.