Department of Gynaecologic Oncology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Int J Gynecol Cancer. 2010 Jul;20(5):869-73. doi: 10.1111/IGC.0b013e3181df7423.
This paper describes the results of a retrospective study of surgical approaches and recurrence rates relating to patients with squamous cell carcinoma (SCC) of the vulva. The aim of this study was to analyze the histological margins in relation to recurrence rate and survival.
A retrospective chart review of 93 cases of vulvar cancer. The data collected included clinicopathological and surgical characteristics and the following potential risk factors: pathological margin distance, less than 8 mm; stromal invasion depth, more than 2.5 mm; tumor size; and presence of benign or premalignant epithelial disorders.
Ninety-three patients (median age, 74 years) underwent modified radical vulvectomy, hemi-vulvectomy, or local wide excision for SCC of the vulva from 2000 to 2005. The tumor was radically removed in 80 patients (86%), although the histopathological margin was less than 8 mm in 50 patients (54%). Eighteen patients (23%) developed a local recurrence. The recurrence rate did not differ between patients in whom the margin distance was 8 mm or more and those in whom the margin distance was less than 8 mm, (23% and 22%, respectively). The median follow-up was 31 months (range, 2-90 months).
Several studies showed that pathological margin distance of more than 8 mm is an important predictor for local recurrence. This finding was not confirmed in the present study.
本文描述了一项回顾性研究的结果,该研究涉及与外阴鳞状细胞癌(SCC)患者相关的手术入路和复发率。本研究旨在分析组织学边缘与复发率和生存率的关系。
对 93 例外阴癌病例进行回顾性图表审查。收集的数据包括临床病理和手术特征以及以下潜在风险因素:病理边缘距离<8mm;间质浸润深度>2.5mm;肿瘤大小;良性或癌前上皮病变的存在。
2000 年至 2005 年,93 例(中位年龄 74 岁)患者因外阴 SCC 接受改良根治性外阴切除术、外阴半切除术或局部广泛切除术。尽管 50 例患者(54%)的组织病理学边缘<8mm,但有 80 例患者(86%)彻底切除了肿瘤。18 例(23%)患者出现局部复发。边缘距离≥8mm和<8mm 的患者复发率无差异(分别为 23%和 22%)。中位随访时间为 31 个月(范围 2-90 个月)。
多项研究表明,病理边缘距离>8mm 是局部复发的重要预测因素。本研究未证实这一发现。