Woelber, Linn, Griebel, Lis-Femke, Eulenburg, Christine, Sehouli, Jalid, Jueckstock, Julia ORCID: 0000-0001-9550-5324, 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 and Mahner, Sven (2016). Role of tumour-free margin distance for loco-regional control in vulvar cancer-a subset analysis of the Arbeitsgemeinschaft Gynakologische Onkologie CaRE-1 multicenter study. Eur. J. Cancer, 69. S. 180 - 189. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0852

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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 <8mm 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. (C) 2016 Elsevier Ltd. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Woelber, LinnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Griebel, Lis-FemkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eulenburg, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sehouli, JalidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jueckstock, JuliaUNSPECIFIEDorcid.org/0000-0001-9550-5324UNSPECIFIED
Hilpert, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Gregorio, NikolausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasenburg, AnnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ignatov, AtanasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hillemanns, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuerst, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Strauss, Hans-GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baumann, Klaus H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thiel, Falk C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mustea, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meier, WernerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Harter, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wimberger, PaulineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hanker, Lars ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmalfeldt, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Canzler, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fehm, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luyten, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellriegel, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kosse, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heiss, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hantschmann, PeerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mallmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tanner, BernoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfisterer, JacobusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Richter, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neuser, PetraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mahner, SvenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-254295
DOI: 10.1016/j.ejca.2016.09.038
Journal or Publication Title: Eur. J. Cancer
Volume: 69
Page Range: S. 180 - 189
Date: 2016
Publisher: ELSEVIER SCI LTD
Place of Publication: OXFORD
ISSN: 1879-0852
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SQUAMOUS-CELL CARCINOMA; RECURRENCE; MANAGEMENT; PATTERNS; T1Multiple languages
OncologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/25429

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