Abstract：
BACKGROUND: Vulval cancer is a rare gynaecological malignancy. In this study, we present a tertiary centre case analysis to examine the recurrence patterns and survival outcomes of vulval squamous cell carcinoma (SCC).
METHODS: This is a retrospective cohort study of women who received treatment at Oxford University Hospitals between February 2010 and July 2022 for primary vulval SCC.
RESULTS: We included 98 cases. The median age at diagnosis was 68 years. Human Papillomavirus (HPV) infection and lichen sclerosis were observed in 21 and 50 cases, respectively. Surgical excision was the primary treatment. Recurrence within 2 years was more common with advanced stage (p = 0.047, RR = 2.26) and extracapsular lymph node spread (p = 0.013, RR = 2.88). Local recurrence was not associated with a specific cut-off value for tumour-free margin. Poor survival outcomes were observed with higher grade (p = 0.01), advanced FIGO stage (p < 0.001), HPV-independent cancer (p = 0.048), lymph node involvement (p < 0.001, HR = 7.14), extracapsular spread (p < 0.001, HR = 7.93), lymphovascular space invasion (p = 0.002, HR = 3.17), tumour diameter wider than 23 mm (p = 0.029, HR = 2.53) and depth of invasion more than 6 mm (p = 0.006, HR = 3.62). Perineural invasion is associated with shorter disease-free survival. Five-year cancer-specific survival rates for stages I, III, and IV were 90.2%, 40.8%, and 14.3%, respectively.
CONCLUSIONS:
METHODS: This is a retrospective cohort study of women who received treatment at Oxford University Hospitals between February 2010 and July 2022 for primary vulval SCC.
RESULTS: We included 98 cases. The median age at diagnosis was 68 years. Human Papillomavirus (HPV) infection and lichen sclerosis were observed in 21 and 50 cases, respectively. Surgical excision was the primary treatment. Recurrence within 2 years was more common with advanced stage (p = 0.047, RR = 2.26) and extracapsular lymph node spread (p = 0.013, RR = 2.88). Local recurrence was not associated with a specific cut-off value for tumour-free margin. Poor survival outcomes were observed with higher grade (p = 0.01), advanced FIGO stage (p < 0.001), HPV-independent cancer (p = 0.048), lymph node involvement (p < 0.001, HR = 7.14), extracapsular spread (p < 0.001, HR = 7.93), lymphovascular space invasion (p = 0.002, HR = 3.17), tumour diameter wider than 23 mm (p = 0.029, HR = 2.53) and depth of invasion more than 6 mm (p = 0.006, HR = 3.62). Perineural invasion is associated with shorter disease-free survival. Five-year cancer-specific survival rates for stages I, III, and IV were 90.2%, 40.8%, and 14.3%, respectively.
CONCLUSIONS:
摘要：
背景：外阴癌是一种罕见的妇科恶性肿瘤。在这项研究中,我们提供了一项三级中心病例分析,以检查外阴鳞状细胞癌(SCC)的复发模式和生存结局.
方法：这是一项回顾性队列研究，研究对象是2010年2月至2022年7月在牛津大学医院接受原发性外阴SCC治疗的妇女。
结果：我们包括98例。诊断时的中位年龄为68岁。在21和50例中观察到人乳头瘤病毒（HPV）感染和扁平苔藓硬化，分别。手术切除是主要治疗方法。2年内复发更常见的是晚期（p=0.047，RR=2.26）和囊外淋巴结转移（p=0.013，RR=2.88）。局部复发与无瘤边缘的特定临界值无关。较高等级的患者观察到较差的生存结果(p=0.01)，高级FIGO阶段(p<0.001)，与HPV无关的癌症（p=0.048），淋巴结受累（p<0.001，HR=7.14），囊外扩散（p<0.001，HR=7.93），淋巴管间隙侵犯（p=0.002，HR=3.17），肿瘤直径大于23毫米（p=0.029，HR=2.53），浸润深度大于6毫米（p=0.006，HR=3.62）。神经周浸润与更短的无病生存期相关。I期癌症特异性五年生存率，III,IV为90.2%，40.8%,和14.3%，分别。
结论：
方法：这是一项回顾性队列研究，研究对象是2010年2月至2022年7月在牛津大学医院接受原发性外阴SCC治疗的妇女。
结果：我们包括98例。诊断时的中位年龄为68岁。在21和50例中观察到人乳头瘤病毒（HPV）感染和扁平苔藓硬化，分别。手术切除是主要治疗方法。2年内复发更常见的是晚期（p=0.047，RR=2.26）和囊外淋巴结转移（p=0.013，RR=2.88）。局部复发与无瘤边缘的特定临界值无关。较高等级的患者观察到较差的生存结果(p=0.01)，高级FIGO阶段(p<0.001)，与HPV无关的癌症（p=0.048），淋巴结受累（p<0.001，HR=7.14），囊外扩散（p<0.001，HR=7.93），淋巴管间隙侵犯（p=0.002，HR=3.17），肿瘤直径大于23毫米（p=0.029，HR=2.53），浸润深度大于6毫米（p=0.006，HR=3.62）。神经周浸润与更短的无病生存期相关。I期癌症特异性五年生存率，III,IV为90.2%，40.8%,和14.3%，分别。
结论：
