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Prieske, Katharina; Woelber, Linn; Muallem, Mustafa Zelal; Eulenburg, Christine; Jueckstock, Julia Kathrin; Hilpert, Felix; de Gregorio, Nikolaus; Iborra, Severine; Ignatov, Atanas; Hillemanns, Peter; Fuerst, Sophie; Strauss, Hans-Georg; Baumann, Klaus; Beckmann, Matthias; Mustea, Alexander; Meier, Werner; Harter, Philipp; Wimberger, Pauline; Sehouli, Jalid and Mahner, Sven (2021): Age, treatment and prognosis of patients with squamous cell vulvar cancer (VSCC)- analysis of the AGO-CaRE-1 study. In: Gynecologic Oncology, Vol. 161, No. 2: pp. 442-448

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Abstract

and (chemo)radiation were independent prognostic factors for death or recurrence in multivariate analysis. 2year 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 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 in-creased 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. (c) 2021 ELSEVIER. All rights reserved.

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