Katharina Prieske1, Nicole Haeringer1, Donata Grimm1, Fabian Trillsch2, Christine Eulenburg3, Eike Burandt4, Barbara Schmalfeldt1, Sven Mahner2, Volkmar Mueller1, Linn Woelber5. 1. Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 2. Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Gynecology and Obstetrics, University of Munich, Munich, Germany. 3. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: lwoelber@uke.de.
Abstract
OBJECTIVE: Metastatic vulvar cancer is a rare disease. Information on metastatic patterns and corresponding prognosis or therapeutic approaches is scarce. We therefore analyzed pattern and course of metastatic disease in a large single center cohort. METHODS: All patients with primary squamous-cell cancer of the vulvar [n=391, median age: 60years (range 20-94)] treated at the Gynecological Cancer Center Hamburg-Eppendorf 1996-2013 were retrospectively evaluated for occurrence of distant metastasis. Furthermore, a systematic Medline database search was performed using the terms: 'vulvar cancer' AND 'metastasis', 'chemotherapy', 'patterns of recurrence', or 'prognosis'. RESULTS: Out of 391 patients with primary squamous cell vulvar cancer, 20 patients (5.1%) eventually presented with distant metastases. In these 20 patients, median time to first diagnosis of metastasis after primary diagnosis was 13.4months (range 4-104). Often patients experienced one or more local recurrences before distant spread (12/20, 60.0%). Documented metastatic sites were lung (n=9), liver (n=7), bone (n=5), skin (n=4) and lymph-nodes (axillary/thoracic/paraaortic, n=3). The majority of patients presented with unilocal metastases (13/20, 65.0%). In univariate analysis tumor diameter, invasion depth, nodal status and number of metastatic lymph-nodes were identified predictive for occurrence of distant metastases. 2-year-overall-survival-rate after metastases of all metastatic patients was 11.3%; median survival from first diagnosis of metastases was 5.6months. CONCLUSION: The occurrence of distant metastasis from vulvar cancer is a rare event with very limited prognosis. Further efforts, especially translational research will be crucial to identify prognostic markers as well as therapeutic targets to improve survival in these patients.
OBJECTIVE:Metastatic vulvar cancer is a rare disease. Information on metastatic patterns and corresponding prognosis or therapeutic approaches is scarce. We therefore analyzed pattern and course of metastatic disease in a large single center cohort. METHODS: All patients with primary squamous-cell cancer of the vulvar [n=391, median age: 60years (range 20-94)] treated at the Gynecological Cancer Center Hamburg-Eppendorf 1996-2013 were retrospectively evaluated for occurrence of distant metastasis. Furthermore, a systematic Medline database search was performed using the terms: 'vulvar cancer' AND 'metastasis', 'chemotherapy', 'patterns of recurrence', or 'prognosis'. RESULTS: Out of 391 patients with primary squamous cell vulvar cancer, 20 patients (5.1%) eventually presented with distant metastases. In these 20 patients, median time to first diagnosis of metastasis after primary diagnosis was 13.4months (range 4-104). Often patients experienced one or more local recurrences before distant spread (12/20, 60.0%). Documented metastatic sites were lung (n=9), liver (n=7), bone (n=5), skin (n=4) and lymph-nodes (axillary/thoracic/paraaortic, n=3). The majority of patients presented with unilocal metastases (13/20, 65.0%). In univariate analysis tumor diameter, invasion depth, nodal status and number of metastatic lymph-nodes were identified predictive for occurrence of distant metastases. 2-year-overall-survival-rate after metastases of all metastatic patients was 11.3%; median survival from first diagnosis of metastases was 5.6months. CONCLUSION: The occurrence of distant metastasis from vulvar cancer is a rare event with very limited prognosis. Further efforts, especially translational research will be crucial to identify prognostic markers as well as therapeutic targets to improve survival in these patients.
Authors: Erik A Williams; Adrienne J Werth; Radwa Sharaf; Meagan Montesion; Ethan S Sokol; Dean C Pavlick; Molly McLaughlin-Drubin; Rachel Erlich; Helen Toma; Kevin Jon Williams; Jeff M Venstrom; Brian M Alexander; Nikunj Shah; Natalie Danziger; Amanda C Hemmerich; Eric A Severson; Jonathan Keith Killian; Douglas I Lin; Jeffrey S Ross; Julie Y Tse; Shakti H Ramkissoon; Mark C Mochel; Julia A Elvin Journal: JCO Precis Oncol Date: 2020-06-16
Authors: Katharina Prieske; Malik Alawi; Anna Jaeger; Maximilian Christian Wankner; Kathrin Eylmann; Susanne Reuter; Patrick Lebok; Eike Burandt; Niclas C Blessin; Barbara Schmalfeldt; Leticia Oliveira-Ferrer; Simon A Joosse; Linn Woelber Journal: Cancers (Basel) Date: 2021-12-19 Impact factor: 6.639