Details

Autor(en) / Beteiligte

• Woelber, Linn
• Griebel, Lis-Femke
• Eulenburg, Christine
• Sehouli, Jalid
• Jueckstock, Julia
• Hilpert, Felix
• de Gregorio, Nikolaus
• Hasenburg, Annette
• Ignatov, Atanas
• Hillemanns, Peter
• Fuerst, Sophie
• Strauss, Hans-Georg
• Baumann, Klaus H
• Thiel, Falk C
• Mustea, Alexander
• Meier, Werner
• Harter, Philipp
• Wimberger, Pauline
• Hanker, Lars Christian
• Schmalfeldt, Barbara
• Canzler, Ulrich
• Fehm, Tanja
• Luyten, Alexander
• Hellriegel, Martin
• Kosse, Jens
• Heiss, Christoph
• Hantschmann, Peer
• Mallmann, Peter
• Tanner, Berno
• Pfisterer, Jacobus
• Richter, Barbara
• Neuser, Petra
• Mahner, Sven

Titel

Role of tumour-free margin distance for loco-regional control in vulvar cancer—a subset analysis of the Arbeitsgemeinschaft Gynäkologische Onkologie CaRE-1 multicenter study

Ist Teil von

• European journal of cancer (1990), 2016-12, Vol.69, p.180-188

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Aim of the study A tumour-free pathological resection margin of ≥8 mm is considered state-of-the-art. Available evidence is based on heterogeneous cohorts. This study was designed to clarify the relevance of the resection margin for loco-regional control in vulvar cancer. Methods AGO-CaRE-1 is a large retrospective study. Patients ( n  = 1618) with vulvar cancer ≥ FIGO stage IB treated at 29 German gynecologic-cancer-centres 1998–2008 were included. This subgroup analysis focuses on solely surgically treated node-negative patients with complete tumour resection ( n  = 289). Results Of the 289 analysed patients, 141 (48.8%) had pT1b, 140 (48.4%) pT2 and 8 (2.8%) pT3 tumours. One hundred twenty-five (43.3%) underwent complete vulvectomy, 127 (43.9%) partial vulvectomy and 37 (12.8%) radical local excision. The median minimal resection margin was 5 mm (1 mm–33 mm); all patients received groin staging, in 86.5% with full dissection. Median follow-up was 35.1 months. 46 (15.9%) patients developed recurrence, thereof 34 (11.8%) at the vulva, after a median of 18.3 months. Vulvar recurrence rates were 12.6% in patients with a margin <8 mm and 10.2% in patients with a margin ≥8 mm. When analysed as a continuous variable, the margin distance had no statistically significant impact on local recurrence (HR per mm increase: 0.930, 95% CI: 0.849–1.020; p  = 0.125). Multivariate analyses did also not reveal a significant association between the margin and local recurrence neither when analysed as continuous variable nor categorically based on the 8 mm cutoff. Results were consistent when looking at disease-free-survival and time-to-recurrence at any site (HR per mm increase: 0.949, 95% CI: 0.864–1.041; p  = 0.267). Conclusions The need for a minimal margin of 8 mm could not be confirmed in the large and homogeneous node-negative cohort of the AGO-CaRE database.