Predicting the course of disease in recurrent vulvar cancer - A subset analysis of the AGO-CaRE-1 study

TY - JOUR

T1 - Predicting the course of disease in recurrent vulvar cancer - A subset analysis of the AGO-CaRE-1 study

AU - Woelber, Linn

AU - Eulenburg, Christine

AU - Kosse, Jens

AU - Neuser, Petra

AU - Heiss, Christoph

AU - Hantschmann, Peer

AU - Mallmann, Peter

AU - Tanner, Berno

AU - Pfisterer, Jacobus

AU - Jückstock, Julia

AU - Hilpert, Felix

AU - de Gregorio, Nikolaus

AU - Iborra, Severine

AU - Sehouli, Jalid

AU - Ignatov, Atanas

AU - Hillemanns, Peter

AU - Fürst, Sophie

AU - Strauss, Hans-Georg

AU - Mahner, Sven

AU - Prieske, Katharina

AU - AGO-CaRE 1 investigators

N1 - Copyright © 2019 Elsevier Inc. All rights reserved.

PY - 2019/9

Y1 - 2019/9

N2 - OBJECTIVE: In vulvar cancer (VSCC), the course of disease with regard to localization of recurrence and relation of different recurrence sites is poorly described.METHODS: The AGO CaRE-1 study is a retrospective survey of treatment patterns and prognostic factors in vulvar cancer. Patients (pts) with primary VSCC, FIGO stage ≥1B treated in Germany from 1998 to 2008 were included in a centralized database (n = 1618). In the current subgroup analysis, different sites of primary recurrence and their impact on disease course and survival were analyzed using multistate and competing risks methods.RESULTS: 1249 pts with surgical groin staging and known lymph-node status (35.8% N+) were included in the analysis. 360 pts (28.8%) developed disease recurrence; thereof 193 (53.6%) at the vulva only, with a cumulative incidence of 12.6% after 2 years. Generally, prognosis after disease depended on recurrence site: Hazard ratios (HRs) (95% confidence interval) to die for pts with compared to without recurrence at the same time: vulvar only: 5.9 (4.3-8.2); groins only: 6.0 (3.0-10.2); vulvar and groins: 14.1 (7.6-26.4); pelvic/distant: 21.2 (15.3-29.4). Fifty-eight (30.1%) pts with local recurrence developed second recurrence. 2-year mortality after any recurrence was 56.3%. After vulvar recurrence pts had a 2-year and 5-year overall survival rate of 82.2% and 66.9%.CONCLUSIONS: Prognosis after recurrence is highly depending on recurrence site. Pts with isolated vulvar recurrence have an impaired prognosis as many affected pts develop second recurrences.

AB - OBJECTIVE: In vulvar cancer (VSCC), the course of disease with regard to localization of recurrence and relation of different recurrence sites is poorly described.METHODS: The AGO CaRE-1 study is a retrospective survey of treatment patterns and prognostic factors in vulvar cancer. Patients (pts) with primary VSCC, FIGO stage ≥1B treated in Germany from 1998 to 2008 were included in a centralized database (n = 1618). In the current subgroup analysis, different sites of primary recurrence and their impact on disease course and survival were analyzed using multistate and competing risks methods.RESULTS: 1249 pts with surgical groin staging and known lymph-node status (35.8% N+) were included in the analysis. 360 pts (28.8%) developed disease recurrence; thereof 193 (53.6%) at the vulva only, with a cumulative incidence of 12.6% after 2 years. Generally, prognosis after disease depended on recurrence site: Hazard ratios (HRs) (95% confidence interval) to die for pts with compared to without recurrence at the same time: vulvar only: 5.9 (4.3-8.2); groins only: 6.0 (3.0-10.2); vulvar and groins: 14.1 (7.6-26.4); pelvic/distant: 21.2 (15.3-29.4). Fifty-eight (30.1%) pts with local recurrence developed second recurrence. 2-year mortality after any recurrence was 56.3%. After vulvar recurrence pts had a 2-year and 5-year overall survival rate of 82.2% and 66.9%.CONCLUSIONS: Prognosis after recurrence is highly depending on recurrence site. Pts with isolated vulvar recurrence have an impaired prognosis as many affected pts develop second recurrences.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Lymph Nodes/pathology

KW - Middle Aged

KW - Multivariate Analysis

KW - Neoplasm Recurrence, Local/pathology

KW - Neoplasm Staging

KW - Prognosis

KW - Proportional Hazards Models

KW - Retrospective Studies

KW - Survival Rate

KW - Vulvar Neoplasms/pathology

KW - Young Adult

U2 - 10.1016/j.ygyno.2019.07.009

DO - 10.1016/j.ygyno.2019.07.009

M3 - SCORING: Journal article

C2 - 31324454

VL - 154

SP - 571

EP - 576

JO - GYNECOL ONCOL

JF - GYNECOL ONCOL

SN - 0090-8258

IS - 3

ER -