Prognostic factors for recurrence and survival in uncommon variants of vulvar cancer

• Published in: Archives of gynecology and obstetrics 2021-03, Vol.303 (3), p.759-766
• Main Authors: Zapardiel, Ignacio, Gracia, Myriam, Díez, Javier, Buda, Alessandro, Noya, Maria C., Iaco, Pierandrea De, Vieira-Baptista, Pedro, Iacoponi, Sara
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Chemotherapy; Chemotherapy, Adjuvant; Endocrinology; Female; Genital cancers; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Lymph Node Excision; Lymph Nodes - pathology; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - pathology; Obstetrics/Perinatology/Midwifery; Prognosis; Radiation therapy; Retrospective Studies; Risk Factors; Survival analysis; Treatment Outcome; Vulvar Neoplasms - pathology; Vulvar Neoplasms - therapy; Vulvectomy
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-020-05813-x

Purpose To analyze the prognostic factors of recurrence and overall survival in rare histotypes of vulvar cancer. Methods An international multicenter retrospective study including patients diagnosed with vulvar cancer was performed. One hundred centers participated in the study and 2453 vulvar cancer cases were enrolled from January 2001 until December 2005. After exclusion of squamous vulvar cancer, Paget´s disease and vulvar melanoma 112 tumors were analyzed for the present study. Results The mean age at diagnosis was 64.9 ± 17.2 years. 99 (88.4%) patients had a single lesion, in 25 (22.3%) cases the vulvar tumor involved the midline, and only 13 (11.5%) patients had clinically positive inguinal lymph nodes. The mean size of the lesion was 33.8 ± 33.9 mm. Regarding the surgical treatment, 2 (1.8%) patients underwent skinning vulvectomy, 63 (56.3%) local excision, 41 (36.6%) vulvectomy, 3 (2.7%) exenteration and 3 (2.7%) did not receive any surgical treatment. The mean free surgical margin was 8.2 ± 9 mm and 7 (6.2%) patients presented positive inguinal nodes. Radiotherapy was administered in 22 (19.6%) patients and it was performed postoperatively in all cases; 14 (12.5%) patients received adjuvant chemotherapy. The mean overall follow-up time was 44.1 ± 35.7 months. The risk factors associated with overall survival were chemotherapy and radiotherapy, tumor size and stromal invasion ( p