Disparities in Vulvar Cancer Reported by the National Cancer Database

Abstract

II.

The Role of Pathological Margin Distance and Prognostic Factors After Primary Surgery in Squamous Cell Carcinoma of the Vulva

“…A study involving the data from the National Cancer Database of the United States showed that patients with advanced stage vulvar cancer are significantly older than the ones with stage I or II disease. 24 Similarly, in our study, patients more than 66 years old tend to have stage IIIYIV disease, compared with younger patients (55% and 26%, respectively; P = 0.04). This may be the reason why older age was associated with recurrence in our study.…”

Vulvar Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology

“…Vulva-confi ned recurrence (nodes clinically negative), not previously irradiated a For margins that are free but close (>0 mm but <8 mm), evidence is lacking to support decreased recurrence and improved survival with re-resection of disease or adjuvant local radiation to the primary tumor site. 2,4 VULVA-B 1 OF 4…”

“…Adjuvant local radiation therapy is another alternative. 4 The risk-benefi t ratio and morbidity of these approaches must be considered and individualized in each patient. a • Close or positive margins that involve the urethra, anus, or vagina may not be resectable without incurring signifi cant potential morbidity and adverse impact on patient quality of life.…”

“…Cancer 2002;95:2331-2338. 4 Faul CM, Mirmow D, Huang Q, et al Adjuvant radiation for vulvar carcinoma: improved local control. Int J Radiat Oncol Biol Phys 1997;38:381-389.…”

“…2 Studies of the SEER database and the National Cancer Database have shown that treatment approaches/modalities vary considerably with sociodemographic factors such as race/ethnicity, age, and nonprivate insurance, particularly for patients with advanced disease. 3,4 Ninety percent of vulvar cancers are of squamous cell carcinoma (SCC) histology. 2 Risk factors for the development of vulvar neoplasia include increasing age, infection with HPV, cigarette smoking, inflammatory conditions affecting the vulva, and immunodeficiency.…”