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HPV-associated and HPV-independent vulvar squamous cell carcinoma: is there an impact of resection margins on local recurrence?

  • 0University of Auckland, Department of Health Science and Department of Medicine, Auckland, New Zealand.
International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society +

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March 27, 2025

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March 27, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Local recurrence of vulvar cancer is more common in HPV-independent (HPV-I) than HPV-associated (HPV-A) types. Narrow surgical margins (<8 mm) increase recurrence risk in HPV-I vulvar squamous cell carcinoma.

Area Of Science

  • Gynecologic Oncology
  • Surgical Pathology
  • Oncogenic Viruses

Background

  • Vulvar squamous cell carcinoma (VSCC) recurrence is a significant clinical concern.
  • Human papillomavirus (HPV) status is a key factor in VSCC pathogenesis and prognosis.
  • The role of surgical resection margins in VSCC recurrence requires further clarification, particularly concerning HPV status.

Purpose Of The Study

  • To evaluate the impact of resection margins on the first local recurrence of VSCC.
  • To stratify this impact based on HPV-associated (HPV-A) and HPV-independent (HPV-I) tumor status.
  • To investigate the association between precursor lesions at resection margins and VSCC recurrence risk.

Main Methods

  • Retrospective single-center review of 360 VSCC cases treated surgically (1990-2020).
  • Clinicopathological data and follow-up information were analyzed.
  • Univariable and multivariable survival analyses assessed the impact of pathological margins (<8 mm) on local recurrence, stratified by HPV status.

Main Results

  • Local recurrences were significantly higher in HPV-I (27.3%) versus HPV-A (7.2%) VSCC (p < .001).
  • Pathological margins <8 mm were significantly associated with increased local recurrence in HPV-I VSCC (aHR 2.06, p = .0017).
  • No significant association between margin status and recurrence was found for HPV-A VSCC.

Conclusions

  • HPV status is critical in predicting local recurrence risk in VSCC.
  • Narrow surgical margins (<8 mm) are an independent risk factor for local recurrence in HPV-I VSCC.
  • Incorporating HPV status into management protocols can aid in risk-stratifying follow-up care for VSCC patients.

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