Surgical-pathologic variables predictive of local recurrence in squamous cell carcinoma of the vulva

Heaps, JM; Fu, YS; Montz, FJ; Hacker, N F; Berek, J. S.

doi:10.1016/0020-7292(91)90185-8

Cited by 73 publications

(112 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, there was a difference in the appearance of the tumour margins; the boundaries between the control tumours and the surrounding dermal tissue were poorly defined with clusters of carcinoma cells invading the dermis (Figure 5E upper panels). This pattern of invasion resembles the 'spray' pattern of invasion observed in VSCC (Heaps et al, 1990;Qureshi et al, 1999). In contrast, the boundaries of integrin b1 knockdown tumours were better-defined and were often encapsulated by fibroblasts aligned parallel to the tumour edge ( Figure 5E, lower panels).…”

Section: In Vivo Analysis Of Integrin B1 Functionsupporting

confidence: 52%

“…Death from VSCC is caused by tumour invasion into local tissues resulting either directly in haemorhage, sepsis or uraemia from bilateral ureteric obstruction or indirectly in inanition. There are two distinct patterns of VSCC invasion into surrounding tissue: a 'pushing' pattern displays distinct tumour -stroma boundaries, whereas a 'spray' pattern of invasion is characterised by ill-defined tumour -stroma boundaries with small clusters of invading cells and correlates with poor prognosis (Heaps et al, 1990;Qureshi et al, 1999). Understanding the molecular mechanisms of VSCC invasion will aid developing strategies to combat this life-threatening aspect of the disease.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Integrin β1 is required for the invasive behaviour but not proliferation of squamous cell carcinoma cells in vivo

et al. 2004

View full text Add to dashboard Cite

Integrin b1 is both overexpressed and in an 'active' conformation in vulval squamous cell carcinomas (VSCCs) compared to matched normal skin. To investigate the significance of integrin b1 deregulation we stably knocked-down integrin b1 expression in the VSCC cell line A431. In vitro analysis revealed that integrin b1 is required for cell adhesion, cell spreading and invasion. However, integrin b1 is not required for cell growth or activation of FAK and ERK signalling in vitro or in vivo. Strikingly, while control tumours were able to invade the dermis, integrin b1 knockdown tumours were significantly more encapsulated and less invasive.

show abstract

Section: In Vivo Analysis Of Integrin B1 Functionsupporting

confidence: 52%

mentioning

confidence: 99%

Integrin β1 is required for the invasive behaviour but not proliferation of squamous cell carcinoma cells in vivo

et al. 2004

View full text Add to dashboard Cite

show abstract

“…These results are comparable to those from the study by Heaps et al, who found a 50% local recurrence rate in patients with margins measuring Ͻ 8 mm. 33 In our study, 50% of patients had histologic tumor free margins measuring Յ 8 mm despite the intended surgical margins of 1 cm. The high percentage of patients with histologic margins Յ 8 mm may be related to shrinkage due to fixation.…”

Section: Discussionmentioning

confidence: 53%

Vulvar carcinoma

Hullu

Hollema²,

Lolkema³

et al. 2002

Cancer

249

View full text Add to dashboard Cite

BACKGROUNDThe objective of this study was to determine whether modifications in the treatment of patients with vulvar carcinoma influence the rates of recurrence and survival.METHODSBetween 1982 and 1997, 253 patients with T1 and T2 invasive squamous cell carcinoma of the vulva were treated by essentially the same team of gynecologic oncologists, and 168 patients (Group I) underwent radical vulvectomy with en bloc inguinofemoral lymphadenectomy. Standard therapy was changed in 1993, and 85 patients (Group II) underwent wide local excision with inguinofemoral lymphadenectomy through separate incisions. The rates of recurrence and survival were compared between both groups.RESULTSIn Group II, the overall recurrence rate (33.3%) within 4 years was increased compared with Group I (19.9%; P = 0.03). In Group II, 5 of 79 patients (6.3%) developed fatal groin or skin bridge recurrences compared with 2 of 159 patients (1.3%) in Group I (P = 0.029); this did not result in a difference in overall survival. In Group II, 40 of 79 patients had tumor free margins measuring ≤ 8 mm, resulting in 9 local recurrences; whereas 39 of 79 patients had tumor free margins measuring > 8 mm, resulting in no local recurrences (P = 0.002).CONCLUSIONSThe current study showed that fatal recurrences in either the groin or the skin bridge were more frequent after wide local excision and inguinofemoral lymphadenectomy through separate incisions; however, probably due to lack of power, this did not result in shorter survival. In 40 of 79 patients, the histologic margins measured ≤ 8 mm, resulting in a high risk of local recurrences. Therefore, the authors recommend obtaining surgical margins of 2 cm for the local treatment of patients with vulvar carcinoma. Cancer 2002;95:2331–8. © 2002 American Cancer Society.DOI 10.1002/cncr.10969

show abstract

“…These advances were enabled by better understanding of the prognosis or course of the disease. [8][9][10][11] The conventional prognostic tool is FIGO staging system. 12 This system is based on tumor size, lymph node status, and presence of distant metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…These include the number of positive inguinal-femoral lymph nodes 14 , omission of lymphadenectomy, and margin status. 10 Therefore, a nomogram, which incorporates more clinical and pathologic factors than the staging system, can allow the clinician to achieve a better estimation of the prognosis of an individual patient. Another potential benefit of nomogram is that it creates a simple graphical representation of a statistical predictive model that generates a numerical probability of a clinical event.…”

Section: Discussionmentioning

confidence: 99%

Validation of a nomogram for predicting outcome of vulvar cancer patients, primarily treated by surgery, in Korean population: multicenter retrospective study through Korean Gynecologic Oncology Group (KGOG-1010)

Kim

Lee

et al. 2008

J Gynecol Oncol

View full text Add to dashboard Cite

Objective: Regarding vulvar cancer, a nomogram has been suggested for the prediction of relapse-free survival (RFS). While the nomogram has been developed and validated in a Western study, there was no validation in Korean population. Thus, we have undertaken the study to assess the applicability of nomogram for predicting RFS in Korean patients with vulvar cancer. Methods: A total of 204 cases newly diagnosed as vulvar cancer between 1982 and 2006 were identified. Among them 70 cases were not eligible due to inappropriate cell type (40 cases) and radiation as primary therapy (30 cases). Fortyfour cases were not evaluable due to inadequate data and persistent disease. Finally a total of 90 patients primarily treated by surgery were included for analysis. Variables including age and the characteristics of primary tumor, nodal status, and surgical margin were collected for predicting RFS based on nomogram, which was compared with actual RFS. A calibration plot was drawn showing the actual versus predicted probability for 6 groups of patients segregated according to their predicted probabilities. In addition, discrimination of the nomogram was quantified with the concordance index. Results: Patients' mean age was 58 years and mean follow-up period was 47.9 months. Observed 2y-and 5y-RFS rates were 81% and 68%, respectively, corresponding to 79% and 72% in the original cohort. The trend line in calibration plot showed comparable concordance with an ideal line, having a slope of 1.04 for 2y-RFS (R 2 =.35) and 0.98 for 5y-RFS (R 2 =.80), respectively. The concordance index was 0.79 in the KGOG data set, which was improved to 0.82 with the data set limited to squamous cell carcinoma. Conclusion:The nomogram provides the predictive capacity for relapse-free survival in Korean patients with vulvar cancer.

show abstract

Surgical-pathologic variables predictive of local recurrence in squamous cell carcinoma of the vulva

Cited by 73 publications

References 0 publications

Integrin β1 is required for the invasive behaviour but not proliferation of squamous cell carcinoma cells in vivo

Integrin β1 is required for the invasive behaviour but not proliferation of squamous cell carcinoma cells in vivo

Vulvar carcinoma

Validation of a nomogram for predicting outcome of vulvar cancer patients, primarily treated by surgery, in Korean population: multicenter retrospective study through Korean Gynecologic Oncology Group (KGOG-1010)

Contact Info

Product

Resources

About