Assessment of recurrence rate and risk factors of relapse in stage in IA vulvar carcinoma

Objective. To evaluate recurrence rates and risk factors of relapse in stage IA vulvar squamous cell carcinoma (VSCC) patients. Material and methods. Population-based prospectively collected data on stage IA VSCC was retrieved through the Danish Gynecological Cancer Database (DGCD) during 2011-2017. A central pathology review was performed on tumors from women with recurrent disease. Results. 62 women diagnosed and treated for stage IA VSCC were identified. Nine (14.5%) of the included cases relapsed within the observation period. The recurrences were in the vulva, groins or both in 5 (8.1%), 3 (4.8%) and 1 (1.6%) of the women. respectively. At central pathology review, including all recurrent cases (n = 9), 5 out of 21 reviewed patients were upstaged to stage IB due to depth of invasion >1 mm and two were downstaged to Carcinoma in situ. Two of the upstaged women developed an isolated groin recurrence and one an isolated vulvar relapse. Alter exclusion of the seven cases the overall recurrence rate decreased to 10.9% (n = 6). Among these cases (n = 55) resection margin <8 mm and tumor size were associated with cancer recurrence. Conclusion. Pathological assessment of stage IA VSCC (depth of invasion 51 mm) may be difficult. This may result in under-staging, which impact the choice of treatment and possibly the prognosis. This suggests a need for further clarification of the FIGO measurement and may require a more radical approach when it comes to treatment and groin exploration in stage IA VSCC. Resection margins <8 mm and tumor size were associated with relapse of the disease. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study evaluated recurrence rates and risk factors of relapse in stage IA vulvar squamous cell carcinoma patients, finding that resection margins <8 mm and tumor size were associated with cancer recurrence. The study suggested that pathological assessment of stage IA VSCC may be difficult and further clarification of measurement methods is needed.