Predicting the course of disease in recurrent vulvar cancer – A subset analysis of the AGO-CaRE-1 study

Woelber, Linn; Eulenburg, Christine; Kosse, Jens; Neuser, Petra; Heiss, C.; Hantschmann, Peer; Mallmann, Peter; Berno, Tamara; Pfisterer, Jacobus; Jückstöck, Julia; Hilpert, Felix; Gregorio, Nikolaus de; Iborra, Séverine; Sehouli, Jalid; Ignatov, Atanas; Hillemanns, Peter; Fürst, Sophie; Strauß, Hans‐Georg; Mahner, Sven

doi:10.1016/j.ygyno.2019.07.009

Cited by 20 publications

(17 citation statements)

References 16 publications

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“…Our study population consisted of unselected patients, including not only clinically early‐stage cases but also those with advanced stages, neoadjuvant chemotherapy, extensive nodal metastases, and recurrent disease. Furthermore, the incidence of isolated relapse was 4.2%, which agrees with those from previous studies 24–26 . Thus, there was a low risk of bias in our main findings.…”

Section: Discussionsupporting

confidence: 92%

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Proposal for modified inguinofemoral lymphadenectomy derived from investigation of anatomic distribution of sentinel and metastatic nodes in vulvar cancer

Liu

Chen

et al. 2020

Journal of Surgical Oncology

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ObjectiveWe aimed to develop a less invasive inguinofemoral lymphadenectomy (IFL) approach for vulvar cancer based on the investigation of the anatomic distribution of sentinel and metastatic nodes.MethodsPatients with vulvar cancer treated by surgery between 1995 and 2019 were retrospectively reviewed. A seven‐field method was adopted to assign the anatomic locations for lymph nodes removed via IFL or sentinel node biopsy. Only patients with nodal metastasis or sentinel nodes were included.ResultsA total of 102 patients with eligible data were analyzed. Nodal metastasis was confirmed in 118 groins undergoing IFL; sentinel node detection succeeded in 46 groins. The medial‐inguinal field had the highest rate of nodal metastasis involvement (59.3%, 70/118) and sentinel nodes present (73.9%, 34/46). The inferior‐femoral field was involved only in one groin with quadruple‐field metastases. The lateral‐inguinal field was not involved in any groin. Neither the lateral‐inguinal nor the inferior‐femoral field presented sentinel nodes.ConclusionThe lateral‐inguinal and inferior‐femoral fields of the groins have a low risk of developing nodal metastasis. Therefore, a modified IFL preserving these fields can be established to reduce surgical morbidity without sacrificing its therapeutic effect.

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Section: Discussionsupporting

confidence: 92%

“…Furthermore, the incidence of isolated relapse was 4.2%, which agrees with those from previous studies. [24][25][26] Thus, there was a low risk of bias in our main findings. With this, we believe that the classical technique of IFL can be modified to avoid unnecessary resection of lymphatic tissue, while capturing all the metastatic nodes.…”

Section: Discussionmentioning

confidence: 71%

Proposal for modified inguinofemoral lymphadenectomy derived from investigation of anatomic distribution of sentinel and metastatic nodes in vulvar cancer

Liu

Chen

et al. 2020

Journal of Surgical Oncology

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“…However, the authors did not report the data of multivariate analysis for these factors. Woelber et al [8] performed a subset analysis of AGO (Arbeitsgemeinschaft Gynäkologische Onkologie)-CaRE (Chemo and Radiotherapy in Epithelial Vulvar Cancer)-1 study [12]. The AGO-care study is a large retrospective study from 29 gynecologic cancer centers in Germany aimed to evaluate the bene t of adjuvant therapy in lymph node-positive vulvar cancer.…”

Section: Discussionmentioning

confidence: 99%

“…We recently reported the series of 145 SCCA vulva cancer patients and found the common recurrent sites were groin and vulva regions with unfavorable survival outcomes [6]. Previous publications identi ed some clinicopathologic factors such as tumor size, depth of invasion, margin -status, tumor grade, lymph vascular space invasion (LVSI), groin node involvement, and age were affect the recurrence and survival outcomes [4,[7][8][9]. However, with the small numbers in previous studies and limited data in the Asian population, we conducted this retrospective study to analyze the clinicopathological factors in uencing the survival outcomes.…”

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confidence: 99%

Clinicopathological Prognostic Factors Influencing Survival Outcomes of Vulvar Cancer

Muangchang

Suprasert

Khunamornpong

2021

Preprint

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Backgroud: Squamous cell carcinoma (SCCA) is the most common vulva cancer. This study purpose to evaluate the clinicopathological prognostic factors for survival outcomes of this disease after treated with surgery. Methods: All SCCA vulva cancer patients who underwent surgery between January 2006 and December 2017 were reviewed. The clinicopathological factors were analyzed to identify the prognostic factors for the progression-free survival (PFS) and overall survival (OS) using the Kaplan- Meier method and Cox-Proportional Hazard model.Results: One hundred twenty-five patients were recruited with a median age of 57 years. The recurrence rate was 35.2%. Patients with recurrence revealed a significant poorer five-year OS rate than those who did not recur (23.7% vs. 79.4%, P < 0.001). About 58.1% of palpable groin nodes revealed metastasis. The independent poor prognostic factors for PFS were groin node-positive and a tumor diameter more than 25 mm. whereas postmenopausal status, preoperative tumor area more than 11 cm2, and groin node enlargement were independent poor prognostic factors for OS. Conclusion: Groin node-positive and tumor diameter longer than 25 mm. were independent poor prognostic factors for PFS whereas postmenopausal status, large tumor area than 11 cm2, and enlargement of groin nodes were independent poor prognostic factors for OS. Patients with these factors should be closely followed.

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“…Local recurrences are usually treated with a curative intention and median 5-year survival for this group is reported to be between 53% and 76% [14][15][16]. Groin recurrences occur less often, but carry a markedly worse prognosis, with a 5-year-survival of less than 30% [15,17]. Women without regional spread have a low risk for groin recurrences.…”

Section: Introductionmentioning

confidence: 99%

Patterns of recurrence and survival in vulvar cancer: A nationwide population-based study

Zach

Åvall‐Lundqvist

Falconer

et al. 2021

Gynecologic Oncology

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In this nationwide population-based cohort, the overall recurrence rate was 22.3%.• The 5-year cumulative incidence rate for isolated local recurrence was only 14.7%.• Median 4-year overall survival post local recurrence was poor, 37.4%.• Surgical groin staging was omitted in 23.7% of FIGO stages IB-II.• Omitting surgical groin staging in FIGO stages IB-II was significantly associated with poor survival.

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Predicting the course of disease in recurrent vulvar cancer – A subset analysis of the AGO-CaRE-1 study

Cited by 20 publications

References 16 publications

Proposal for modified inguinofemoral lymphadenectomy derived from investigation of anatomic distribution of sentinel and metastatic nodes in vulvar cancer

Proposal for modified inguinofemoral lymphadenectomy derived from investigation of anatomic distribution of sentinel and metastatic nodes in vulvar cancer

Clinicopathological Prognostic Factors Influencing Survival Outcomes of Vulvar Cancer

Patterns of recurrence and survival in vulvar cancer: A nationwide population-based study

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