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

Journal article


Publication Details

Author(s): Woelber L, Griebel LF, Eulenburg C, Sehouli J, Jueckstock J, Hilpert F, De Gregorio N, Hasenburg A, Ignatov A, Hillemanns P, Fuerst S, Strauss HG, Baumann KH, Thiel F, Mustea A, Meier W, Harter P, Wimberger P, Hanker LC, Schmalfeldt B, Canzler U, Fehm T, Luyten A, Hellriegel M, Kosse J, Heiss C, Hantschmann P, Mallmann P, Tanner B, Pfisterer J, Richter B, Neuser P, Mahner S
Journal: European journal of cancer
Publication year: 2016
Volume: 69
Pages range: 180-188
ISSN: 0959-8049


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.


FAU Authors / FAU Editors

Thiel, Falk PD Dr.
Medizinische Fakultät


Additional Organisation
Lehrstuhl für Geburtshilfe und Frauenheilkunde


External institutions with authors

Alb Fils Kliniken
Charité - Universitätsmedizin Berlin
Elblandkliniken
Evangelisches Krankenhaus Düsseldorf
Georg-August-Universität Göttingen
Kliniken Essen-Mitte
Klinikum Wolfsburg
Koordinierungszentrum für Klinische Studien der Philipps-Universität Marburg
Kreiskliniken Altötting-Burghausen
Ludwig-Maximilians-Universität (LMU)
Martin-Luther-Universität Halle-Wittenberg (MLU)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Oberhavel Klinik Oranienburg
Otto-von-Guericke-Universität Magdeburg
Philipps-Universität Marburg
Sana Klinikum Offenbach
Technische Universität Dresden
Universitätsklinikum Düsseldorf
Universitätsklinikum Frankfurt
Universitätsklinikum Freiburg
Universitätsklinikum Hamburg-Eppendorf (UKE)
Universitätsklinikum Köln
Universitätsklinikum Schleswig-Holstein (UKSH)
Universitätsmedizin Greifswald / Universitätsklinikum Greifswald
Universität Ulm


How to cite

APA:
Woelber, L., Griebel, L.-F., Eulenburg, C., Sehouli, J., Jueckstock, J., Hilpert, F.,... Mahner, S. (2016). 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. European journal of cancer, 69, 180-188. https://dx.doi.org/10.1016/j.ejca.2016.09.038

MLA:
Woelber, Linn, et al. "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." European journal of cancer 69 (2016): 180-188.

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Last updated on 2018-14-11 at 09:23