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P186 Surgical treatment of vulvar cancer: impact of tumor-free margin distance on recurrence and survival. A multicentre cohort analysis from the francogyn study group
  1. E Raimond1,
  2. C Delorme1,
  3. L Ouldamer2,
  4. X Carcopino3,
  5. S Bendifallah4,
  6. C Touboul5,
  7. E Daraï4,
  8. M Ballester4 and
  9. O Graesslin1
  1. 1Department of Obstetrics and Gynaecology, Institute Alix de Champagne, University Hospital REIMS, Reims Cedex
  2. 2Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours
  3. 3Department of Obstetrics and Gynaecology, Hopital Nord, APHM, Marseilles
  4. 4Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris
  5. 5Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Faculté de Médecine de Créteil UPEC – Paris XII, Creteil, France


Introduction/Background In vulvar cancer, it is admitted that tumor-free margin distance is one of the most important element for locoregional control. It is currently recommended to surgically remove the tumor with at least an 8 mm tumor-free margin. The aim of this study was to evaluate the impact of tumor-free margin distance on recurrence and survival in vulvar cancer.

Methodology From 2005 to 2016, 112 patients surgically treated for a vulvar squamous cell cancer were included in a retrospective multicenter study. Overall, disease-free and metastasis-free survivals were analyzed according to tumor-free margin distance.

Results Patients were divided into three groups : group 1 (margin <3 mm, n=47) ; group 2 (margin ≥3 mm to <8 mm, n=48) and group 3 (margin ≥8 mm, n=17). During the study, 26,8% patients developed recurrence (n=30) after a median of 8 months (1–69). Analysis of 5-year overall survival, as well as disease-free and metastasis-free survivals, did not reveal a difference between groups. We performed a subgroup analysis in patients with a tumor-free margin <8 mm (group 1 and 2). It showed that histological lesions observed closest to the edge of the specimen were more often invasive or in situ carcinoma lesions in group 1 than in group 2, in which VIN lesions were mainly observed at this location. After re-excision, no patients in group 1 and 50% (n=2) patients in group 2 developed recurrence.

Conclusion This study did not reveal a significant impact of tumor-free margin distance on recurrence and survival in vulvar cancer. Moreover, the benefit of re-excision seems stronger when tumor-free margins are positive or very close (<3 mm), cases in which invasive or in situ lesions are often present closest to the edge of the specimen.

Disclosure Nothing to disclose.

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