Pelvic Exenteration for Recurrent Vulvar Cancer: A Retrospective Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Statistical Analysis
2.3. Assessment of Perioperative Morbidity
2.4. Immunohistochemistry
2.5. Literature Review
3. Results
3.1. Patient Data Analysis
3.2. Data Analysis
3.3. Complications
3.4. Literature Review
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient | Age at Surgery (Years) | Type of PE | Number of Recurrence | T-Stadium | N-Status | M-Status | L-Status | V-Status | R-Status | Grading | Indication for Surgery | Neoadjuvant Treatment | Adjuvant Treatment | p16-Status | p53-Status |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 47 | total | 4th | rpT3 | pN1 | M0 | L0 | V0 | R0 | G2 | curative | no | yes | negative | mutation |
2 | 81 | anterior | 4th | rpT3 | pNx | M0 | L0 | V0 | R0 | G2 | curative | no | no | negative | mutation |
3 | 70 | anterior | 1st | rpT3 | cN0 | M0 | L0 | V0 | R0 | G2 | curative | no | no | negative | mutation |
4 | 74 | posterior | 3rd | yrpT4 | pNx | cM1 (PUL) | L0 | V0 | R1 | G2 | palliative | yes | unknown | negative | wildtype |
5 | 70 | total | 1st | rpT3 | pN0 | cM0 | L1 | V1 | R0 | G3 | curative | no | no | positive | wildtype |
6 | 41 | anterior | 1st | rpT3 | pN0 | cM0 | L0 | V0 | R1 | G2 | curative | no | yes | unknown | unknown |
7 | 65 | anterior | 1st | rpT3 | pN0 | cM0 | L0 | V0 | R0 | G2 | curative | no | no | negative | mutation |
8 | 65 | anterior | 1st | rpT4 | pN0 | cM0 | L1 | V0 | R1 | G2 | curative | no | no | negative | mutation |
9 | 53 | anterior | 1st | rpT3 | pN1 | cM0 | L1 | V0 | R1 | G2 | curative | no | no | negative | mutation |
10 | 43 | anterior | 2nd | ypT2 | pNx | cM0 | L0 | V0 | R0 | G2 | curative | yes | yes | negative | mutation |
11 | 77 | anterior | 1st | rpT2 | pNx | cM0 | L0 | V0 | R0 | G2 | curative | no | no | negative | mutation |
12 | 70 | total | 2nd | rpT3 | pN0 | Mx | L0 | V0 | R0 | G2 | curative | no | no | positive | wildtype |
13 | 72 | anterior | 1st | rpT3 | pN0 | pM1 (SKI) | L0 | V0 | R1 | G2 | palliative | no | unknown | negative | wildtype |
14 | 63 | posterior | 1st | rpT2 | pNx | cM0 | L0 | V0 | R1 | G2 | curative | no | no | negative | mutation |
15 | 78 | posterior | 3rd | rpT2 | pNx | cM0 | L0 | V0 | R0 | G2 | curative | no | no | negative | mutation |
16 | 74 | posterior | 1st | rpT2 | pNx | cM0 | L0 | V0 | R0 | G2 | curative | no | no | positive | wildtype |
17 | 61 | anterior | 1st | rpT3 | pN0 | cM0 | L0 | V0 | R0 | G3 | curative | no | no | negative | mutation |
Independent Variable | Hazard Ratio [Confidence Interval] |
---|---|
Age at Surgery | 0.98 [95% CI 0.931.04] |
Blood Vessel Invasion | 0.04 [95% CI non-applicable] |
Complete Cytoreduction | 6.3 [95% CI 1.02–39.03] |
Complications (Clavien–Dindo classification ≤2/>2) | 1.6 [95% CI 0.42–6.04] |
Indication for Surgery | 14.0 [95% CI 0.88–223.87] |
Distant Metastases | 14.0 [95% CI 0.88–223.87] |
Lymphatic Metastases | 0.19 [95% CI 0.41–103.92] |
Lymphatic Vessel Invasion | 1.18 [95% CI 0.13–10.66] |
p16-status | 0.46 [95% CI 0.06–3.67] |
p53-status | 1.04 [95% CI 0.21–5.05] |
Tumor Grading | 0.04 [95% CI 0.0–83.06] |
T-Stadium (rT3 vs. rT2/rT4 vs. rT2) | 1.09 [95% CI 0.27–4.48]/4.12 [95% CI 0.37–46.14] |
Patient No. | Complication According to the Clavien–Dindo Classification [12] |
---|---|
1 | 3b (postoperative defect coverage) |
2 | 4a (postoperative dialysis) |
3 | 2 |
4 | 1 |
5 | 1 |
6 | 1 |
7 | 1 |
8 | 3b (surgery anastomotic leakage ileum) |
9 | 2 |
10 | 3b (postoperative defect coverage) |
11 | 1 |
12 | 2 |
13 | 3b (wound debridement) |
14 | 1 |
15 | 2 |
16 | 3b (ureteral stents) |
17 | 1 |
Study | Study Type | Patient Group | Number of Patients | Median Age (Years) | 5-Year OS | Factor Influencing OS |
---|---|---|---|---|---|---|
Valstad et al., 2023 [19] | single center; retrospective | primary locally advanced (53%), recurrent (47%) vulvar cancer | 30 | 66 | 50% | None |
Abdulrahman et al., 2022 [20] | single center; retrospective | primary locally advanced (74%), recurrent (26%) vulvar cancer | 19 | 65 | all: 66.7% primary disease: 69.3% recurrent disease: 60% | primary: lymphovascular invasion recurrent: none |
Forner et al., 2011 [22] | single center; retrospective | primary locally advanced (33%), recurrent (64%) vulvar cancer | 27 | 66 | all: 62% primary disease: 62% recurrent disease: 59% | lymph node involvement, resection status (R0) |
Hopkins et al., 1992 [21] | single center; retrospective | primary locally advanced (58%), recurrent (42%) vulvar cancer | 19 | 50 | 60% | lymph node involvement |
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Classen-von Spee, S.; Baransi, S.; Fix, N.; Rawert, F.; Luengas-Würzinger, V.; Lippert, R.; Bonin-Hennig, M.; Mallmann, P.; Lampe, B. Pelvic Exenteration for Recurrent Vulvar Cancer: A Retrospective Study. Cancers 2024, 16, 276. https://doi.org/10.3390/cancers16020276
Classen-von Spee S, Baransi S, Fix N, Rawert F, Luengas-Würzinger V, Lippert R, Bonin-Hennig M, Mallmann P, Lampe B. Pelvic Exenteration for Recurrent Vulvar Cancer: A Retrospective Study. Cancers. 2024; 16(2):276. https://doi.org/10.3390/cancers16020276
Chicago/Turabian StyleClassen-von Spee, Sabrina, Saher Baransi, Nando Fix, Friederike Rawert, Verónica Luengas-Würzinger, Ruth Lippert, Michelle Bonin-Hennig, Peter Mallmann, and Björn Lampe. 2024. "Pelvic Exenteration for Recurrent Vulvar Cancer: A Retrospective Study" Cancers 16, no. 2: 276. https://doi.org/10.3390/cancers16020276