caa a22 4500 445338822 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1778-0 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1778-0 Prognostic Value of Pathological Resection Margin Distance in Squamous Cell Cancer of the Vulva [Elektronische Daten] [Linn Woelber, Matthias Choschzick, Christine Eulenburg, Matthaeus Hager, Fritz Jaenicke, Friederike Gieseking, Lilli Kock, Maike Ihnen, Cordula Petersen, Joerg Schwarz, Sven Mahner] Background: A tumor-free resection margin of at least 8mm is considered state of the art in vulvar cancer. This standard is based on small and heterogeneous patient cohorts, and its implementation can result in mutilation. Methods: One hundred two consecutive patients with primary squamous cell vulvar cancer were analyzed. All patients received resection of the primary tumor and the inguinofemoral lymph nodes via three separate incisions, resulting in complete tumor resection. Median follow-up was 31months. Minimal margin distances were pathologically determined in all dimensions after fixation. Results: Median age of the patients was 62years; 38.2% had International Federation of Gynecology and Obstetrics (FIGO) stage I, 17.6% stage II, 24.4% stage III, and 8.8% stage IV disease. The median minimal resection margin was 5mm (range 0.5-25mm). Sixteen patients (15.6%) developed disease recurrence, of whom 10 (62.5%) at the vulva. Margin distance had no significant impact on disease-free survival when analyzed continuously (p=0.388). When cases were divided into three subgroups of <3mm (28.4%), ≥3 to <8mm (42.2%), and ≥8mm (29.4%) resection margin, neither univariate nor multivariate analysis revealed a difference in disease-free survival. There was no significant difference between any of the subgroups regarding tumor stages and adjuvant radiotherapy of the vulva. These results were independent of the direction of the minimal margin distance and consistent when only vulvar recurrences were analyzed. Conclusions: A tumor-free resection margin is essential for locoregional control in vulvar cancer. However, in this large, single-center study, we could not demonstrate any prognostic impact of pathological margin distance. Society of Surgical Oncology, 2011 Woelber Linn Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Choschzick Matthias Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Eulenburg Christine Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Hager Matthaeus Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Jaenicke Fritz Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Gieseking Friederike Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Kock Lilli Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Ihnen Maike Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Petersen Cordula Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Schwarz Joerg Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Mahner Sven Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3811-3818 1068-9265 18:13<3811 2011 18 10434 https://doi.org/10.1245/s10434-011-1778-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1778-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Woelber Linn Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Choschzick Matthias Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Eulenburg Christine Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Hager Matthaeus Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Jaenicke Fritz Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Gieseking Friederike Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Kock Lilli Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Ihnen Maike Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Petersen Cordula Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Schwarz Joerg Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Mahner Sven Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3811-3818 1068-9265 18:13<3811 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer