Predictors and treatment of ısolated recurrence in vulvar cancer confined to the vulva or perineum

Aim: This study evaluated predictors and treatment of isolated vulvar recurrence (IVR) in patients with stage I–II tumors locally confined to the vulva. Methods: We retrospectively collected data from patients with stage I–II vulvar squamous cell carcinoma (VSCC) who underwent surgery for vulvar cancer between 2005 and 2021. The IVR group comprised patients with stage I–II tumors at the time of initial diagnosis who developed recurrence confined to the vulvar region after initial treatment. Results: This study included 416 patients with early-stage (stage I–II) VSCC. IVR was developed in 67 (16.1%) patients; the remaining 349 patients were included in the control group. Independent predictors of IVR were depth of invasion, perineural invasion, and positive surgical margins. Among patients with tumors confined to the vulva at the time of initial diagnosis, the 5-year overall survival rates were 59.0% and 87.0% in the IVR and control groups, respectively (P < 0.001). In the IVR group, the cumulative rates of local relapse were 38.8% in the first year, 58.2% in the second year, and 74.6% in the third year. Conclusion: Independent predictors of IVR in early-stage VSCC were depth of invasion, perineural invasion, and positive surgical margins. Approximately two-thirds of local recurrences occurred in the first 3 years after treatment.