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Patterns of recurrence and survival in vulvar cancer: A nationwide population-based study
Karolinska Univ Hosp, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
Karolinska Univ Hosp, Sweden.
Karolinska Univ Hosp, Sweden.
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2021 (English)In: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 161, no 3, p. 748-754Article in journal (Refereed) Published
Abstract [en]

Objective. To examine the patterns of recurrence and how these patterns are associated with survival in vulvar squamous cell carcinoma. We also explored the survival impact of surgical groin staging (SGS). Methods. Nationwide population-based study including women diagnosed with vulvar squamous cell carcinoma between 2012 and 2015 and registered in the Swedish Quality Registry for Gynecologic Cancer. Cumulative incidence rates (CIR), recurrence-free (RFS) and overall survival (OS) were calculated by Kaplan Meier estimates. The impact of SGS on RFS and OS was analyzed by proportional hazards models. Results. 489 eligible women were included. Median follow-up time was 64 months. The overall recurrence rate was 22.3%. Site of recurrence: local in 61.0%, groin in 30.0%, distant in 9.0%. The CIR for local recurrences increased with time (5.9% at 2-years, 14.7% at 5-years) while the rate of groin and distant recurrences was nearly steady (5.5% to 6.3% and 1.5% to 1.7%, respectively). Median 2-year and 4-year OS post-recurrence was 57.8% and 37.4% for local, 17.2%, 10.3% for groin and 0% for distant recurrences, respectively. SGS was omitted in 23.7% of surgically treated women with FIGO stages IB-II and significantly associated with worse RFS (Hazard ratio, HR, 1.9; 95%CI, 1.0-3.5; p = 0.04) and OS (HR 2.0; 95%CI, 1.1-3.8; p = 0.04) after adjustment for age, FIGO stage, tumor size, resection margins and performance status. Conclusion. The cumulative incidence of isolated vulvar recurrence was low but for those affected the prognosis was poor. Surgical groin staging is a crucial part of primary treatment and should not be omitted. (c) 2021 Published by Elsevier Inc.

Place, publisher, year, edition, pages
ACADEMIC PRESS INC ELSEVIER SCIENCE , 2021. Vol. 161, no 3, p. 748-754
Keywords [en]
Vulvar cancer; Population-based research; Recurrence
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-176855DOI: 10.1016/j.ygyno.2021.03.013ISI: 000654681200018PubMedID: 33736857OAI: oai:DiVA.org:liu-176855DiVA, id: diva2:1571005
Note

Funding Agencies|Swedish Society for Gynecologic Cancer

Available from: 2021-06-22 Created: 2021-06-22 Last updated: 2021-08-13

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Åvall Lundqvist, Elisabeth
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