Defining and quantifying histopathologic risk factors for regional and distant metastases in a large cohort of vulvar squamous cell carcinomas

Vulvar squamous cell carcinoma (vSCC) is a rare tumor with a good prognosis when treated at a localized stage. However, once regional/distant metastasis occurs, vSCC can be rapidly fatal. Thus, it is important to identify tumor prognostic features so that high-risk cases can be prioritized for furth...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2023-11, Vol.89 (5), p.1022-1030
Main Authors: Cheraghlou, Shayan, Doudican, Nicole A., Criscito, Maressa C., Stevenson, Mary L., Carucci, John A.
Format: Article
Language:English
Subjects:
cutaneous
histopathologic
NCDB
risk factors
sentinel lymph node biopsy
squamous cell carcinoma
vulvar
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Summary:Vulvar squamous cell carcinoma (vSCC) is a rare tumor with a good prognosis when treated at a localized stage. However, once regional/distant metastasis occurs, vSCC can be rapidly fatal. Thus, it is important to identify tumor prognostic features so that high-risk cases can be prioritized for further diagnostic workup and treatment. To estimate the risk of regional/distant metastasis at presentation and sentinel lymph node status for vSCC based on histopathologic characteristics. A retrospective cohort study of 15,188 adult vSCC cases from the National Cancer Database diagnosed from 2012 to 2019. We provide specific estimates of the risk of clinically positive nodes and metastatic disease at presentation and sentinel lymph node positivity according to tumor size, moderate/poor tumor differentiation, and lymph-vascular invasion. These histopathologic factors were all significantly associated with the tested clinical outcomes in a multivariable analysis. Moderate (hazard ratio, 1.190; P 
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2023.03.049