Klamminger Gilbert Georg, Bitterlich Annick, Nigdelis Meletios P, Schnöder Laura, Hamoud Bashar Haj, Solomayer Erich-Franz, Wagner Mathias
Department of General and Special Pathology, Saarland University (USAAR), 66424 Homburg, Germany.
Department of General and Special Pathology, Saarland University Medical Center (UKS), 66424 Homburg, Germany.
J Clin Med. 2024 Jul 11;13(14):4058. doi: 10.3390/jcm13144058.
: Vulvar cancer (VC) comprises a small fraction of female neoplasms with notable high-incidence clusters among German regions. Despite a proposed impact of nationwide lockdowns in response to the COVID-19 pandemic on oncological diseases, the effect on VC staging and tumor characteristics remains yet to be resolved; therefore, analyzing pathological data from patients with squamous cell VC pre-, during, and post-COVID in a high-incidence region may offer insights into potential epidemiological and clinical trends. : We identified a total of 90 patients who were diagnosed at the Institute of Pathology, University Hospital Saarland, between 2018 and 2023, and defined three distinct cohorts: a pre-COVID cohort (2018-2019), a COVID cohort (2020-2021), and a post-COVID cohort (2022-2023). Histomorphological data were collected from the individual patient reports and statistically analyzed using Fisher's exact test or the Kruskal-Wallis test. : Although we found no statistically significant differences in age, T-stage, perineural infiltration, blood vessel infiltration, resection status, grading, or resection margin between our three cohorts, surprisingly, we determined a greater extent of lymphovascular infiltration (Fisher's exact test; = 0.041), as well as deeper tumor infiltration depth (Kruskal-Wallis test; < 0.001) before the COVID-19 pandemic. Furthermore, we did not identify any soft indications of abnormalities in patient care within our center (unchanged status of the resection margins across all three cohorts). : Our results clearly do not support a negative affection of clinical or pathobiological characteristics of VC during or after the pandemic. However, final assessments regarding the pandemic's effect on VC require additional study approaches in various regions, preferably with future extended timeframes of a longer follow-up.
外阴癌(VC)在女性肿瘤中占比小,但在德国各地区有明显的高发病聚集区。尽管针对新冠疫情实施的全国封锁措施对肿瘤疾病有潜在影响,但对VC分期和肿瘤特征的影响仍有待明确;因此,分析高发病区鳞状细胞VC患者在新冠疫情前、疫情期间及疫情后的病理数据,可能有助于了解潜在的流行病学和临床趋势。
我们共确定了90例于2018年至2023年在萨尔兰大学医院病理研究所确诊的患者,并将其分为三个不同队列:新冠疫情前队列(2018 - 2019年)、新冠疫情队列(2020 - 2021年)和新冠疫情后队列(2022 - 2023年)。从个体患者报告中收集组织形态学数据,并使用Fisher精确检验或Kruskal - Wallis检验进行统计分析。
虽然我们发现三个队列在年龄、T分期、神经周围浸润、血管浸润、切除状态、分级或手术切缘方面无统计学显著差异,但令人惊讶的是,我们确定在新冠疫情大流行之前,淋巴管浸润程度更高(Fisher精确检验;P = 0.041),肿瘤浸润深度更深(Kruskal - Wallis检验;P < 0.001)。此外,我们未发现本中心患者护理存在任何异常的轻微迹象(所有三个队列的手术切缘状态未变)。
我们的结果显然不支持疫情期间或疫情后VC的临床或病理生物学特征受到负面影响。然而,关于疫情对VC影响的最终评估需要在不同地区采用额外的研究方法,最好是未来延长随访时间框架。