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
| Autor: | Ria Winkelmann, Khayal Gasimli, Ahmed El-Balat, Martina Straussner, Thomas Karn, Iryna Schmeil, Sven Becker |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Reoperation 0301 basic medicine medicine.medical_specialty Gastroenterology Disease-Free Survival Vulva 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Stage (cooking) Grading (tumors) Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over Univariate analysis Vulvar Neoplasms business.industry Proportional hazards model Margins of Excision Obstetrics and Gynecology Retrospective cohort study General Medicine Middle Aged Vulvar cancer Prognosis Vulvar intraepithelial neoplasia medicine.disease Survival Rate 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Neoplasm Recurrence Local business Carcinoma in Situ |
| Zdroj: | Archives of Gynecology and Obstetrics. 298:945-950 |
| ISSN: | 1432-0711 0932-0067 |
| Popis: | 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.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.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).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. |
| Databáze: | OpenAIRE |
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