Age, treatment and prognosis of patients with squamous cell vulvar cancer (VSCC) - analysis of the AGO-CaRE-1 study

Prieske K, Woelber L, Muallem MZ, Eulenburg C, Jueckstock JK, Hilpert F, de Gregorio N, Iborra S, Ignatov A, Hillemanns P, Fuerst S, Strauss HG, Baumann K, Beckmann M, Mustea A, Meier W, Harter P, Wimberger P, Sehouli J, Mahner S (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Gynecologic Oncology Elsevier

DOI: 10.1016/j.ygyno.2021.02.025

Abstract

Background: Despite an increasing incidence with simultaneous decreasing age of onset, vulvar squamous cell carcinoma (VSCC) is still a disease that mainly effects the elderly population. Data on the association of age with prognosis and treatment patterns in VSCC are sparse. Methods: This is an analysis of the AGO-CaRE-1 cohort. Patients with VSCC (FIGO stage ≥1B), treated at 29 cancer centers in Germany from 1998 to 2008, were included in a centralized database (n = 1618). In this subgroup analysis patients were analyzed according to age [<50 yrs. (n = 220), 50–69 yrs. (n = 506), ≥70 yrs. (n = 521)] with regard to treatment patterns and prognosis. Only patients with documented age, surgical groin staging and known nodal status were included (n = 1247). Median follow-up was 27.5 months. Results: At first diagnosis, women ≥70 yrs. presented with more advanced tumor stages (<0.001), larger tumor diameter (<0.001), poorer ECOG status (<0.001), more frequent HPV negative tumors (p = 0.03) as well as a higher rate of nodal involvement (<0.001). Disease recurrence occurred significantly more often in elderly patients (p = 0.001) and age as well as ECOG status, microscopic residual resection, tumor stage, grading, and (chemo)radiation were independent prognostic factors for death or recurrence in multivariate analysis. 2-year disease-free survival rates were 59.3% (≥70 yrs), 65.8% (50–69 yrs) and 81.1% (<50 yrs), respectively (p < 0.001). Conclusions: Older women with VSCC present with advanced tumor stages at first diagnosis and have an increased risk of recurrence as well as a decreased 2-year DFS in comparison to younger patients. Potential reasons could be self-awareness and/or more aggressive tumor biology due to HPV independent disease.

Authors with CRIS profile

Matthias Beckmann Lehrstuhl für Geburtshilfe und Frauenheilkunde

Involved external institutions

Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Klinikum der Universität München DE Germany (DE) Krankenhaus Jerusalem DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Universitätsklinikum Aachen (UKA) DE Germany (DE) Universitätsklinikum Magdeburg A.ö.R. DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Universitätsklinikum Halle (Saale) DE Germany (DE) Klinikum der Stadt Ludwigshafen am Rhein gGmbH DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Universitätsklinikum Düsseldorf DE Germany (DE) Kliniken Essen-Mitte DE Germany (DE) Technische Universität Dresden DE Germany (DE)

How to cite

APA:

Prieske, K., Woelber, L., Muallem, M.Z., Eulenburg, C., Jueckstock, J.K., Hilpert, F.,... Mahner, S. (2021). Age, treatment and prognosis of patients with squamous cell vulvar cancer (VSCC) - analysis of the AGO-CaRE-1 study. Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2021.02.025

MLA:

Prieske, Katharina, et al. "Age, treatment and prognosis of patients with squamous cell vulvar cancer (VSCC) - analysis of the AGO-CaRE-1 study." Gynecologic Oncology (2021).

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