Table 1

Demographic and clinical characteristics of women with vulvar cancer

Group 1
Tumors ≥4 cm
(n=36)
Group 2
Multifocal tumors
(n=17)
Groups 3 and 4*
First local recurrence
(n=11)
Number of operated groins, n (%)69 (95.8)34 (100)17 (77.3)
Age (years), median (IQR)73 (68–80)74 (60–78)67 (57–76)
BMI (kg/m2), median (IQR)26 (21–30)30 (27–33)30 (26–33)
Smoking, n (%)
 No32 (88.9)15 (88.2)9 (81.8)
 Yes4 (11.1)2 (11.8)2 (18.2)
Comorbidities†, n (%)
 None7 (19.4)3 (17.7)4 (36.4)
 113 (36.1)6 (35.3)5 81.8)
 ≥216 (44.4)8 (47.1)2 (18.2)
ECOG performance status, n (%)
 0–133 (91.7)14 (82.4)11 (100)
 23 (8.3)3 (17.6)0
FIGO stage‡, n (%)
 IB21 (58.3)9 (52.9)NA
 II1 (2.8)0
 IIIA7 (19.4)3 (17.7)
 IIIB1 (2.8)2 (11.8)
 IIIC6 (16.7)3 (17.7)
Histology, n (%)
 Squamous cell carcinoma36 (100)17 (100)10 (90.9)
 Invasive vulvar Paget's disease01 (9.1)
Pathological tumor size (mm)§, median (IQR)50 (41–57)25 (13–35)26 (4–36)
Focality, n (%)
 Unifocal tumor36 (100)1¶ (5.9)6 (54.6)
 Multifocal tumor16 (94.1)5 (45.4)
Surrounding pre-cancerous lesion**, n (%)
 dVIN15 (41.7)11 (64.7)4 (36.4)
 HSIL9 (25.0)2 (11.8)3 (27.3)
 Both dVIN and HSIL1 (2.8)1 (5.9)0
 Neither dVIN nor HSIL7 (19.4)3 (17.6)3 (27.3)
 Missing4 (11.1)01 (9.1)
p16-immunostaining, n (%)
 Positive13 (36.1)2 (11.8)2 (18.2)
 Negative21 (58.3)13 (76.5)4 (36.4)
 Missing2 (5.6)2 (11.8)5 (45.5)
p53-immunostaining, n (%)
 Positive13 (36.1)9 (52.9)1 (9.1)
 Negative13 (36.1)5 (29.4)3 (27.3)
 Missing10 (27.8)3 (17.7)7 (63.6)
Extent of vulvar surgery, n (%)
 Wide excision26 (72.2)16 (94.1)5 (45.5)
 Complete vulvectomy8 (22.2)1 (5.9)4 (36.4)
 Pelvic exenteration2 (5.6)02 (18.2)
Reconstruction with flap, n (%)
 Yes10 (27.8)3 (17.7)1 (9.1)
 No26 (72.2)14 (82.4)10 (90.9)
Extend of groin surgery, per groin, n (%)72 (100)34 (100)22 (100)
 No groin surgery3†† (4.2)05‡‡ (22.7)
 SLN only006§§ (27.3)
 IFL only due to failed mapping11 (15.9)5 (14.7)5 (22.7)
 IFL and SLN58 (80.1)29 (85.3)6 (27.3)
Surgical excision margin (mm), median (IQR)4 (2–7)6 (3–9)6 (4–7)
Adjuvant treatment, n (%)
 No adjuvant treatment22 (61.1)11 (64.7)9 (81.8)
 Adjuvant radiotherapy5 (13.9)3 (17.6)0
 Adjuvant radiochemotherapy9 (25.0)3 (17.6)2 (18.2)
Radiotherapy targets, n (%)
 Groins and pelvis7 (50.0)4 (66.7)2 (100)
 Vulva2 (14.3)1 (16.7)0
 Vulva, groins, and pelvis5 (35.7)1 (16.7)0
  • Figures indicate number (%) or median (IQR).

  • *Group 3: first local recurrence, no previous groin surgery/SLN only (n=4). Group 4: first local recurrence, previous IFL/radiotherapy (n=7).

  • †Comorbidities comprising cardiac (including hypertonia), pulmonary, diabetes mellitus, renal failure, previous stroke, psychiatric disease, and others.

  • ‡FIGO stage according to the 2009 classification, only for women with primary diagnosis.

  • §Tumor size of the largest tumor focus in multifocal disease.

  • ¶Clinically assessed as multifocal, in pathological analysis unifocal.

  • **Surrounding the invasive tumor in the surgical specimen (pathological assessment).

  • ††Only unilateral groin surgery due to lateral tumor.

  • ‡‡No groin surgery due to failed mapping in women with previous IFL.

  • §§SNB only in women with previous IFL (group 4)

  • BMI, body mass index; dVIN, differentiated vulvar intraepithelial neoplasia; ECOG, Eastern Cooperative Oncology Group; FIGO, International Federation of Gynecology and Obstetrics; HSIL, high-grade squamous intraepithelial lesion; IFL, inguinofemoral lymphadenectomy; NA, not applicable; SLN, sentinel lymph node.