Noortje Pleunis1, Maria E J Leermakers2, Anneke A van der Wurff3, Paul J J M Klinkhamer4, Nicole P M Ezendam5, Dorry Boll6, Joanne A de Hullu7, Johanna M A Pijnenborg8. 1. Department of Obstetrics & Gynecology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands; Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Noortje.Pleunis@radboudumc.nl. 2. Department of Obstetrics & Gynecology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands. 3. Department of Pathology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands. 4. PAMM Laboratories, Department of Pathology, Eindhoven, The Netherlands. 5. Comprehensive Cancer Centre, Eindhoven, The Netherlands; Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands. 6. Department of Obstetrics & Gynecology, Catharina Hospital, Eindhoven, The Netherlands. 7. Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands. 8. Department of Obstetrics & Gynecology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands; Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
INTRODUCTION: The recommended pathological resection margin (8 mm) for vulvar squamous cell carcinoma (SCC) is broader than for SCC located elsewhere, and does not depend on tumor grade or lesion size. Our aim is to evaluate the resection margin in vulvar SCC in relation to local recurrence, and to determine the impact of other prognostic factors. MATERIALS AND METHODS: Data of all surgically treated patients at the Gynecological Oncology Center South with vulvar SCC, FIGO IB-IIIC, between 2005 and 2015 were analysed retrospectively. The relation between the pathological resection margin and other clinicopathological factors with the risk of local recurrence was analysed. RESULTS: In this cohort of 167 patients, the tumor was radically removed in 87% of the patients. Yet, in 57% the pathological resection margin was <8 mm. Including re-excisions, the median closest margin was 7.0 mm. There was no significant difference in the risk of local recurrence for a resection margin <8 mm or ≥8 mm (25.0% (n = 20) and 22.2% (n = 16)), nor in the median resection margin of patients with or without local recurrence (6.5 mm and 7.0 mm). Lichen sclerosus was the only significant risk factor for local recurrence. CONCLUSION: A pathological resection margin <8 mm was not related to an increased risk of local recurrence. The most important predictor of local recurrence was the presence of lichen sclerosus. A resection margin <8 mm in vulvar SCC can therefore be accepted, especially in tumors located close to clitoris, urethra or anus.
INTRODUCTION: The recommended pathological resection margin (8 mm) for vulvar squamous cell carcinoma (SCC) is broader than for SCC located elsewhere, and does not depend on tumor grade or lesion size. Our aim is to evaluate the resection margin in vulvar SCC in relation to local recurrence, and to determine the impact of other prognostic factors. MATERIALS AND METHODS: Data of all surgically treated patients at the Gynecological Oncology Center South with vulvar SCC, FIGO IB-IIIC, between 2005 and 2015 were analysed retrospectively. The relation between the pathological resection margin and other clinicopathological factors with the risk of local recurrence was analysed. RESULTS: In this cohort of 167 patients, the tumor was radically removed in 87% of the patients. Yet, in 57% the pathological resection margin was <8 mm. Including re-excisions, the median closest margin was 7.0 mm. There was no significant difference in the risk of local recurrence for a resection margin <8 mm or ≥8 mm (25.0% (n = 20) and 22.2% (n = 16)), nor in the median resection margin of patients with or without local recurrence (6.5 mm and 7.0 mm). Lichen sclerosus was the only significant risk factor for local recurrence. CONCLUSION: A pathological resection margin <8 mm was not related to an increased risk of local recurrence. The most important predictor of local recurrence was the presence of lichen sclerosus. A resection margin <8 mm in vulvar SCC can therefore be accepted, especially in tumors located close to clitoris, urethra or anus.
Authors: Sebastian Zięba; Anne-Floor W Pouwer; Artur Kowalik; Kamil Zalewski; Natalia Rusetska; Elwira Bakuła-Zalewska; Janusz Kopczyński; Johanna M A Pijnenborg; Joanne A de Hullu; Magdalena Kowalewska Journal: Int J Mol Sci Date: 2020-07-10 Impact factor: 5.923
Authors: Kim E Kortekaas; Koen K Van de Vijver; Mariëtte I E van Poelgeest; C Blake Gilks; Vincent T H B M Smit; Saimah Arif; Deep Arora; Asma Faruqi; Raji Ganesan; Nicholas R Griffin; Richard Hale; Yelin E Hock; Lars-Christian Horn; W Glenn McCluggage; Pinias Mukonoweshuro; Kay J Park; Brian Rous; Bruce Tanchel; Anne-Sophie Van Rompuy; Gerry van Schalkwyk; Jo Vella; Marco Vergine; Naveena Singh; Tjalling Bosse Journal: Int J Gynecol Pathol Date: 2020-09 Impact factor: 3.326