Defining and quantifying histopathologic risk factors for regional and distant metastases in a large cohort of vulvar squamous cell carcinomas - 10/10/23
Abstract |
Background |
Vulvar squamous cell carcinoma (vSCC) is a rare tumor with a good prognosis when treated at a localized stage. However, once regional/distant metastasis occurs, vSCC can be rapidly fatal. Thus, it is important to identify tumor prognostic features so that high-risk cases can be prioritized for further diagnostic workup and treatment.
Objective |
To estimate the risk of regional/distant metastasis at presentation and sentinel lymph node status for vSCC based on histopathologic characteristics.
Methods |
A retrospective cohort study of 15,188 adult vSCC cases from the National Cancer Database diagnosed from 2012 to 2019.
Results |
We provide specific estimates of the risk of clinically positive nodes and metastatic disease at presentation and sentinel lymph node positivity according to tumor size, moderate/poor tumor differentiation, and lymph-vascular invasion. These histopathologic factors were all significantly associated with the tested clinical outcomes in a multivariable analysis. Moderate (hazard ratio, 1.190; P < .001) and poor differentiation (hazard ratio, 1.204; P < .001) and lymph-vascular invasion (hazard ratio, 1.465; P < .001) were also associated with significantly poorer overall survival.
Limitations |
Data on disease-specific survival not available in the data set.
Conclusions |
We demonstrate the association of the histopathologic characteristics of vSCC with clinically important outcomes. These data may provide individualized information when discussing diagnostic/treatment recommendations, particularly regarding sentinel lymph node biopsy. These data may also guide future staging and risk stratification efforts for vSCC.
Il testo completo di questo articolo è disponibile in PDF.Key words : cutaneous, histopathologic, NCDB, risk factors, sentinel lymph node biopsy, squamous cell carcinoma, vulvar
Abbreviations used : AJCC, cSCC, HPV, HR, LVI, NCDB, OR, SLN, SLNB, vSCC
Mappa
| Funding sources: None. |
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| IRB approval status: This study was deemed not to be human subjects research and therefore exempt from IRB review by the NYU Langone IRB. |
Vol 89 - N° 5
P. 1022-1030 - novembre 2023 Ritorno al numero
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