Tumor-free margins and local recurrence in squamous cell carcinoma of the vulva

Jie Yang, Ritchie Delara, Summer Ghaith, Hana Newman, Javier Magrina, Kristina Butler, Amanika Kumar, Tri Dinh, Longwen Chen, Paul Magtibay

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: To investigate the relation of pathologic tumor-free margins and local recurrence in patients who underwent primary surgery for vulvar squamous cell carcinoma. Methods: In this retrospective analysis, patients with stage I-III vulvar squamous cell carcinoma who underwent primary surgery between 2000 and 2018 were identified from the Mayo Clinic Cancer Registry. Results: A total of 335 patients were included and divided into three groups according to tumor-free margins: group 1 (<3 mm, n = 32); group 2 (≥3 to <8 mm, n = 151); group 3 (≥8 mm, n = 152). The median follow-up time was 73 months (range 2–240). A total of 78 (23.3%) patients developed local recurrence. With the inverse propensity score weighing method adjusting baseline characters, margins <8 mm had inferior local control (HR 1.98, 95% CI 1.13–3.41). The 5-year local disease-free survival (DFS) was 48.2%, 81.5% and 84.6% for group 1, 2 and 3 respectively (p < 0.001). There were no differences in groin lymph nodes relapse (p = 0.850), distant metastases (p = 0.253), or disease-specific survival (DSS) (p = 0.289) among the three groups. Margins <8 mm, midline involvement, multifocal disease, precancerous lesions on margins and depth of invasion >1 mm were found to be poor prognosticators for local DFS in univariate analysis. Multifocal disease was the strongest predictor for local recurrence in multivariate analysis (HR 4.32, 95% CI 2.67–6.99). Conclusion: Patients undergoing primary surgery for vulvar squamous cell carcinoma with tumor free-margins <8 mm have a higher local recurrence rate.

Original languageEnglish (US)
Pages (from-to)555-561
Number of pages7
JournalGynecologic oncology
Issue number3
StatePublished - Sep 2020


  • Local recurrence
  • Squamous cell carcinoma
  • Tumor-free margins
  • Vulvar cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology


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