Patterns of recurrence and survival in vulvar cancer: A nationwide population-based study

Zach, Diana; Åvall‐Lundqvist, Elisabeth; Falconer, Henrik; Hellman, Kristina; Johansson, Hemming; Rådestad, Angelique Flöter

doi:10.1016/j.ygyno.2021.03.013

Cited by 22 publications

(15 citation statements)

References 31 publications

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“…Although our understanding of VSCC carcinogenesis has progressed, treatment options for VSCC patients have not significantly evolved over the years [ 13 , 14 ]. The mainstay of VSCC treatment remains surgery with tumor-free resection margins, confirmed on microscopy [ 13 , 14 , 15 ]. Unfortunately, surgical interventions in the vulva may injure adjacent vital structures such as the urethra or the anus, resulting in post-operative morbidity and a reduced quality of life [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring Differentially Methylated Genes in Vulvar Squamous Cell Carcinoma

Dasgupta

Ewing‐Graham

Swagemakers

et al. 2021

Cancers

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DNA methylation is the most widely studied mechanism of epigenetic modification, which can influence gene expression without alterations in DNA sequences. Aberrations in DNA methylation are known to play a role in carcinogenesis, and methylation profiling has enabled the identification of biomarkers of potential clinical interest for several cancers. For vulvar squamous cell carcinoma (VSCC), however, methylation profiling remains an under-studied area. We sought to identify differentially methylated genes (DMGs) in VSCC, by performing Infinium MethylationEPIC BeadChip (Illumina) array sequencing, on a set of primary VSCC (n = 18), and normal vulvar tissue from women with no history of vulvar (pre)malignancies (n = 6). Using a false-discovery rate of 0.05, beta-difference (Δβ) of ± 0.5, and CpG-island probes as cut-offs, 199 DMGs (195 hyper-methylated, 4 hypo-methylated) were identified for VSCC. Most of the hyper-methylated genes were found to be involved in transcription regulator activity, indicating that disruption of this process plays a vital role in VSCC development. The majority of VSCCs harbored amplifications of chromosomes 3, 8, and 9. We identified a set of DMGs in this exploratory, hypothesis-generating study, which we hope will facilitate epigenetic profiling of VSCCs. Prognostic relevance of these DMGs deserves further exploration in larger cohorts of VSCC and its precursor lesions.

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Section: Introductionmentioning

confidence: 99%

Exploring Differentially Methylated Genes in Vulvar Squamous Cell Carcinoma

Dasgupta

Ewing‐Graham

Swagemakers

et al. 2021

Cancers

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“…Although in literature it was described that lymphnode metastasis was the most significant factor, in our study, lymph node metastasis was not found to be statistically significant for recurrence (Figure 1) . Zach et al reported the recurrence rate as 22.3% in their study [12]. They also reported that stage 1 patients had an excellent prognosis.…”

Section: Discussionmentioning

confidence: 84%

Prognostic factors in vulvar cancer patients: a single center experience

Demirtaş¹,

Dinçer²,

Görgülü³

et al. 2021

Pamukkale Medical Journal

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Many prognostic factors have been investigated in vulvar cancer patients. In our study, we aimed to compare clinical and pathological prognostic factors and investigate the factors that affect the recurrence and survival in patients with recurrent and non-recurrent squamous cell vulvar cancer. Materials and methods: This retrospective study was conducted in Tepecik Research Hospital, Izmir, Turkey between 1999-2020. The descriptive features, prognostic factors and survival in recurrent patients were evaluated. Results: Tumor invasion depth, surgical margin positivity, lymphovascular space invasion (LVSI), are statistically significant for recurrence (p=0.03, p=0.00, p=0.04). Variables such as age, tumor size, surgical margin distance (mm), tumor localization, presence of metastatic lymph node, operation type (surgery with lymph node dissection) and adjuvant therapy were not found to be statistically significant in terms of recurrent patients with vulvar cancer. There was correlation between recurrence, LVSI, surgical margin positivity, stage and survival in Kaplan Meier survival analysis. Conclusion:As in other studies, many prognostic factors like tumor invasion depth, surgical margin positivity, LVSI are risk factors for recurrence in our study. Stage, LVSI, recurrence, surgical margin positivity were significant factors for survival as well.

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“…Previous studies reported that the recurrence rate of vulvar cancer ranged from 14.5% to 21.2%, whereas the complication rate was 7.7% to 57.4% after vulvar reconstruction 11,13,18,24,25 . Because of the reconstruction uses the surrounding tissue, vulvar cancer showed a relatively higher recurrence rate in vulvar reconstruction.…”

Section: Discussionmentioning

confidence: 96%

“…Previous studies reported that the recurrence rate of vulvar cancer ranged from 14.5% to 21.2%, whereas the complication rate was 7.7% to 57.4% after vulvar reconstruction. 11,13,18,24,25 Because of the reconstruction uses the surrounding tissue, vulvar cancer showed a relatively higher recurrence rate in vulvar reconstruction. In addition, it showed a high surgical complication rate because the surgical site was a weight bearing site in the sitting position and a site where urine and feces is discharged.…”

Section: Discussionmentioning

confidence: 99%

A Simplified Algorithmic Approach to Vulvar Reconstruction According to Various Types of Vulvar Defects

2023

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Objective Various surgeons adopt various vulvar reconstruction methods for different types of vulvar defects to restore anatomical structures. Vulvar reconstruction has relatively few references as it is performed in many different ways. Our report aimed to create a simplified reconstruction algorithm that can be used to select the reconstruction flap and to compare clinical outcomes. Methods The patients who underwent vulvar reconstruction between April 2017 and May 2020 were retrospectively reviewed. The reconstruction flap was selected according to a suggested algorithm, which accounted for the defect location depending on the vulvo-thigh junctional crease—the visual landmark of the inferior pubic ramus—and proper perforator location. Postoperative surgical complications, functional outcomes, and oncologic outcomes were analyzed according to the histologic and flap types. Results Forty-seven patients underwent reconstruction with 31 internal pudendal artery perforator flaps (66%) and 16 profunda artery perforator flaps or transverse upper gracilis flaps (34%). The histologic type included 21 extramammary Paget disease (44.7%), 20 squamous cell carcinoma (42.6%), and 6 other types (12.8%). Postoperative complications, including wound and functional complications, occurred in 10 patients (21.3%). There were more cases of wound complications with profunda artery perforator flaps and transverse upper gracilis flaps (37.5%) than those with internal pudendal artery perforator flaps (12.9%) (P = 0.04). There were 7 cases (14.9%) of 2-year oncologic recurrence with no significant differences in terms of histologic or flap types. Conclusions According to our suggested simplified algorithm, various types of flaps resulted in reliable surgical outcomes with minimal complication rates and acceptable functional and oncologic outcomes, and the primary goals of vulvar reconstruction were achieved effectively. Using our algorithm, selection of the reconstruction method could be simplified and specified despite the complexity of vulvar defects.

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Patterns of recurrence and survival in vulvar cancer: A nationwide population-based study

Cited by 22 publications

References 31 publications

Exploring Differentially Methylated Genes in Vulvar Squamous Cell Carcinoma

Exploring Differentially Methylated Genes in Vulvar Squamous Cell Carcinoma

Prognostic factors in vulvar cancer patients: a single center experience

A Simplified Algorithmic Approach to Vulvar Reconstruction According to Various Types of Vulvar Defects

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