Characteristic features of recurrences of squamous cell carcinoma of the vulva.

AIM

The objective of this study was to find prognostic factors for the development of recurrences in patients who had undergone surgical treatment of vulvar cancer.

METHODS

The records of patients with primary vulvar cancer (n=104) treated at the Department of Gynaecological Oncology of the Medical University of Gdańsk between 1998 and 2001 were reviewed to identify those with squamous histology. Of the 93 thus identified 27 were excluded because of lack of standard treatment and 7 because of lack of radical surgery. A total number of 59 patients with squamous cell carcinoma were finally analyzed. For each record the age of the patient, size of the lesion, depth of invasion, margins of resection and lymph node status were analyzed. All patients were staged according to FIGO (1996). Recurrences were recorded by localization, whether local, groin or distant, and compared with a group of patients without any recurrences after radical surgery (n=59).

RESULTS

Recurrence was recorded in 19 cases (28.8%). A local (vulvar/perineal) recurrence was diagnosed in 10 patients (10/59, 16.9%), while 5 (5/59, 8.5%) developed groin recurrence and 4 (4/59, 6.8%) had distant recurrences. Multifocality of the primary tumour is an independent risk factor for local recurrence (HR: 3.12; 95% CI: 0.84-11.6). A metastatic node was the only independent prognostic risk factor for groin or distant recurrence (HR: 3.16; 95% CI: 0.94-10.2).

CONCLUSION

Close follow-up of patients treated for vulvar cancer is recommended to detect recurrences at an early and potentially curable stage. Deep inguinal-femoral lymphadenectomy could be replaced with superficial inguinal groin dissection.