Prognostic Factors for Vulvar Cancer Undergoing Primary Surgery: Case Series from a Single Tertiary Cancer Center

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Cancer Research

Background:

• Vulvar squamous cell carcinoma (SCC) is a rare malignancy.
• Primary surgical management is the cornerstone of treatment.
• Identifying prognostic factors is crucial for patient outcomes.

Purpose of the Study:

• To evaluate clinical outcomes in women undergoing primary surgery for vulvar SCC.
• To identify clinicopathological risk factors associated with recurrence and survival.

Main Methods:

• Retrospective cohort analysis of 81 patients (2011-2018).
• Kaplan-Meier method for disease-free survival (DFS) and overall survival (OS) estimation.
• Univariate and multivariate Cox proportional hazards models were used.

Main Results:

• Recurrence occurred in 33.3% of patients; median DFS was 36 months.
• Median OS was 40.8 months.
• Univariate analysis identified depth of invasion (DOI), close margin, lympho-vascular space invasion (LVSI), perineural invasion (PNI), and groin metastases as risk factors for recurrence.
• Multivariate analysis revealed DOI, tumor-free margin (TFM), and PNI significantly impacted DFS, while prior recurrence affected OS.

Conclusions:

• Local tumor factors like TFM, DOI, LVSI, and lymph node status are critical for oncological outcomes in vulvar SCC.
• These findings aid in determining prognosis after primary surgical treatment.
• Larger studies are needed to further validate these prognostic indicators.