J Gynecol Oncol.
2018 Sep;29(5):e61. 10.3802/jgo.2018.29.e61.
Prognostic impact of reduced tumor-free margin distance on long-term survival in FIGO stage IB/II vulvar squamous cell carcinoma
- Affiliations
-
- 1Department of Obstetrics and Gynecology, Sant'Anna Hospital, University of Torino, Turin, Italy. michelettileonardo@gmail.com
- 2Department of Surgical Sciences, Institute of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy.
- 3Department of Pathology and Cytology of Female Cancer, Childhood Cancer, and Rare Cancers, AOU Città della Salute e della Scienza, Turin, Italy.
- KMID: 2417460
- DOI: http://doi.org/10.3802/jgo.2018.29.e61
Abstract
OBJECTIVE
We aimed to identify the minimum tumor-free margin distance conferring long-term oncological safety in patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IB/II vulvar squamous cell carcinoma (VSCC).
METHODS
This was a retrospective cohort study in patients with stage IB/II VSCC treated at a single institution in Turin, Italy. The main aim was to identify the minimum tumor-free margin distance that confers oncological safety in early-stage VSCC. Patients were divided in groups according to tumor-free histological margin distance to compare survival outcomes. Overall survival (OS), disease-specific survival (DSS), and recurrence rate (RR) were estimated by the Kaplan-Meier method for the newly proposed and the currently recommended 8 mm margin cut-off. Log-rank test was used to compare survival between groups.
RESULTS
One hundred and fourteen patients met the study criteria. Median age was 68 years and median follow-up was 80 months. The minimum margin distance that conferred long-term oncological safety was 5 mm. OS, DSS were significantly lower in the < 5 mm group when compared with the ≥ 5 mm group (p = 0.002 and p = 0.033, respectively) although no difference in RR was observed between groups. Analysis at the 8-mm cut-off indicated there is no difference in OS, DSS, or RR between groups.
CONCLUSION
FIGO stage IB/II VSCC patients' prognosis is affected by margin distance. Long-term survival is significantly reduced in patients with tumor-free margins < 5 mm, even in the absence of lymph node metastasis. Thus, these patients should be offered further surgical or adjuvant treatment.
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